| NPI | 1891036166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY CONNER Senior VP & CFO 484-628-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Additional Taxonomies | 207RS0010X Internal Medicine Sports Medicine |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2019-06-17 |