| NPI | 1922465434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYIN C. COLLINS Director 610-485-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |