Organization
MG THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC GRAMATGES PSYD (NEUROPSYCHOLOGIST)
(484) 445-4147
Entity
Organization
Contact information
Practice address
100 W 6TH ST, SUITE 305, SUITE 305, MEDIA, PA 19063-3228
(484) 445-4147
(484) 445-4149
Mailing address
100 W 6TH ST, SUITE 305, SUITE 305, MEDIA, PA 19063-3228
(484) 445-4147
(484) 445-4149
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PS017448
PA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PS017448
PA
103TC0700X
Clinical Psychologist
Primary
PS017448
PA
103TR0400X
Rehabilitation Psychologist
PS017448
PA
Other
Enumeration date
07/31/2014
Last updated
10/21/2016
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