| NPI | 1538501192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA VANSANT President 215-551-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: PA OS010207L) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC006091L) |
| 261QP2300X Clinic/Center, Primary Care (Licence: PA OS010207L) | |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |