| NPI | 1457821670 |
|---|---|
| Doing Business As | IMAGE RECOVERY CENTER OF THE ASPLUNDH PAVILLION |
| Entity Type | Organization |
| Authorized Contact | MICHAEL B WALSH CFO 215-481-2851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |