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General NPI Number Information
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NPI Number | 1871836825
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Entity Type | Organization
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Legal Business Name | FERN HILL HEALTH AND WELLNESS CENTER INC
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 915 OLD FERN HILL RD BULDING D SUITE 500
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City | WEST CHESTER
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State | PA
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Zip | 19380-4269
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Country | US
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Telephone | 610-235-4105
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Fax | 610-235-4108
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Provider Business Mailing Address
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Address Line | 915 OLD FERN HILL RD BUILDING D SUITE 500
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City | WEST CHESTER
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State | PA
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Zip | 19380-4269
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Country | US
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Telephone | 610-235-4105
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Fax | 610-235-4108
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANTONINUS J MANOS
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Credential | DO
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Telephone | 610-235-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS007413E
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License Number State | PA
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