| NPI | 1417673500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON FITCH Office Manager 215-275-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-20 |