| NPI | 1477855104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES D. MICKLE Sole Proprietor 610-952-4418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: NM MD2008-0397) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |