| NPI | 1386813871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMIE BUCKWALTER Billing Clerk 215-659-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD25525L) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |