| NPI | 1982216107 |
|---|---|
| Doing Business As | MIC PA |
| Entity Type | Organization |
| Authorized Contact | LAWRENCE L LIVORNESE Managing Partner 610-896-0210 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |