| NPI | 1518417096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET RIES Pediatric Nurse Practitioner 267-250-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: PA SP016583) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |