| NPI | 1669177911 |
|---|---|
| Doing Business As | TABOR KIDS PEDIATRIC MINI CLINIC |
| Entity Type | Organization |
| Authorized Contact | SUSAN DENISE STUKES Chief Executive Officer 215-844-1020 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-09-20 |