NPI | 1457625535 |
---|---|
Doing Business As | OTOLARYN ASSOC OF FCCC, MGI |
Entity Type | Organization |
Authorized Contact | TONYA WOODARD Credentialing/Manager 215-707-3911 |
Organization Subpart ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology |
Enumeration Date | 2012-03-07 |
Last Update Date | 2018-06-14 |