Organization
COMPLETE PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH WISEMAN (PHYSICIAN)
(215) 533-1333
Entity
Organization
Contact information
Practice address
1216 E HUNTING PARK AVE # 1, PHILADELPHIA, PA 19124-4928
(215) 533-1333
Mailing address
1216 E HUNTING PARK AVE # 1, PHILADELPHIA, PA 19124-4928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OA004049
PA
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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