| NPI | 1538824479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA JOHNSON Owner 215-201-8206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-11-04 |