| NPI | 1467442657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL R. WAGNER Asst Treasurer 215-856-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: PA 11251500) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2013-01-31 |