Organization
ORIGIN FAMILY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA KISLUK (DNP)
(215) 774-9004
Entity
Organization
Contact information
Practice address
1811 BETHLEHEM PIKE STE A101, FLOURTOWN, PA 19031-1111
(215) 774-9004
Mailing address
1811 BETHLEHEM PIKE STE A101, FLOURTOWN, PA 19031-1111
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
09/12/2024
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