Organization
CENTER CITY PEDIATRICS, LLC
Active
Other names
CCP Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BANNETT CPA (PRACTICE ADMINISTRATOR)
(215) 735-5600
Entity
Organization
Contact information
Practice address
1740 SOUTH ST, STE 301, PHILADELPHIA, PA 19146-1514
(215) 735-5600
(215) 735-5690
Mailing address
1740 SOUTH ST, STE 301, PHILADELPHIA, PA 19146-1514
(215) 735-5600
(215) 735-5690
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL002576L
PA
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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