| NPI | 1326677899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY RENEE MACK CEO, Owner 856-305-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2021-09-05 |