| NPI | 1679873970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARATH ALAN MAENPAA Owner 610-209-2912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: PA MD073775-L) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2011-01-04 |