| NPI | 1982245411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA RENEE BLOOM Owner 215-850-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-10-06 |
| Last Update Date | 2019-10-06 |