Individual
BORIS RADISIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
830 W CYPRESS ST, KENNETT SQUARE, PA 19348-2218
(610) 444-6242
(610) 444-1391
Mailing address
737 MEADOWLARK RD, AUDUBON, PA 19403-1913
(610) 666-7695
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
PT004064L
PA
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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