| 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 |