| NPI | 1538463922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MARCELLINO Office Manager 610-825-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA CW016839) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2010-12-29 |