| NPI | 1518216878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN STEMETZKI Owner 856-266-4983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ 44SC05429000) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2012-09-02 |