| NPI | 1851558951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYL B. JACKSON Managment/Owner 215-471-8255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA MD044865L) |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2008-05-18 |