NPI | 1295725711 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTI POTTER Administrator 302-644-6992 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: DE FSSC-012) |
Enumeration Date | 2005-10-26 |
Last Update Date | 2008-06-06 |