| NPI | 1962428391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN MISHOCK Administrator 610-327-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT012572L) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2010-01-24 |