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General NPI Number Information
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NPI Number | 1124510888
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Entity Type | Organization
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Legal Business Name | HEALING PLACE MEDICAL, P.C.
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 1600 HORIZON DR STE 122123
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City | CHALFONT
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State | PA
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Zip | 18914-4100
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Country | US
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Telephone | 267-334-5051
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Fax |
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Provider Business Mailing Address
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Address Line | 550 SHAKESPEARE DR
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City | HARLEYSVILLE
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State | PA
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Zip | 19438-2166
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Country | US
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Telephone | 267-334-5051
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. GREGORY WHITE
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Credential |
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Telephone | 267-334-5051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 8012
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License Number State | PA
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