| NPI | 1740525583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO A. SPOTO Doctor 610-269-7662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PA DC001967L) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |