| NPI | 1922367986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYANN ROTH CEO 215-951-0300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA 138730) |
| Additional Taxonomies | 251S00000X (Licence: PA 138730) |
| 251S00000X (Licence: 138340) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2014-11-12 |