| NPI | 1679699052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN W MCCULLOUGH President 215-946-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: PA DC2206P) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2008-04-20 |