| NPI | 1730592874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL WALKER Program Manager 610-969-4970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT015646) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-06 |