| NPI | 1881932341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BORBIDGE Manager 610-558-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA OEG000297) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: PA OB008953) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |