| NPI | 1467717116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY JASON SMITH Vice President 215-668-4613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: PA MD427776) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2017-02-24 |