| NPI | 1982981536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURA ELLIOTT Office Manager 215-922-4274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: PA MD033646L) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-11-10 |