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 |