| NPI | 1346646601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN SHIPLE Supervising Physician 484-472-8812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: PA OA003437) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2014-11-14 |