Organization
MAIN LINE ALLERGY , L.L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUTHVEN A. WODELL MD (PARTNER)
(610) 642-1643
Entity
Organization
Contact information
Practice address
233 E LANCASTER AVE, SUITE 200, ARDMORE, PA 19003-2321
(610) 642-1643
Mailing address
233 E LANCASTER AVE, SUITE 200, ARDMORE, PA 19003-2321
(610) 642-1643
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194748
HIGHMARK PIN
PA
Enumeration date
05/25/2006
Last updated
05/20/2013
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