| NPI | 1669546792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD MELVIN BLEEDEN Supervising Physician 610-623-4805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA MD034503L) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |