| NPI | 1619711363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE JOHNSON Director Of Operations 484-769-4369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-08-14 |