| NPI | 1902043565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JORDAN ROSS President 610-952-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: PA MD430033) |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2009-01-19 |