| NPI | 1457667859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW SCOTT WOOD Owner 267-879-7256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: PA MD422352) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2010-08-23 |