| NPI | 1710249537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GONDOLFO President 302-730-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C2-0005927) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DE F1-0000323) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2012-10-25 |