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Organization
DOMENICK BRACCIA D.O.
Active
Organization
DOMENICK BRACCIA D.O.
Active
Other names
Haverford Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMENICK BRACCIA D.O. (MEDICAL DIRECTOR)
(610) 924-0600
Entity
Organization
Contact information
Practice address
2010 W CHESTER PIKE, SUITE 310, HAVERTOWN, PA 19083-2700
(610) 924-0600
(610) 924-0627
Mailing address
2010 W CHESTER PIKE, SUITE 310, HAVERTOWN, PA 19083-2700
(610) 924-0600
(610) 924-0627
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
OS006737L
PA
261QI0500X
Infusion Therapy Clinic/Center
OS006737L
PA
261QM1300X
Multi-Specialty Clinic/Center
OS006737L
PA
261QM2500X
Medical Specialty Clinic/Center
Primary
OS006737L
PA
261QP3300X
Pain Clinic/Center
OS006737L
PA
Other
Enumeration date
03/10/2009
Last updated
05/13/2009
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