| NPI | 1407568405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON EVERETT KOOCH Owner 484-357-2469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2022-12-21 |