Organization
FOUNDATION MEDICAL SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GONDOLFO DC (PRESIDENT)
(302) 730-1101
Entity
Organization
Contact information
Practice address
230 BEISER BLVD, SUITE 101, DOVER, DE 19904-7793
(302) 730-1101
Mailing address
230 BEISER BLVD, SUITE 101, DOVER, DE 19904-7793
(302) 730-1101
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
F1-0000323
DE
207Q00000X
Family Medicine Physician
Primary
C2-0005927
DE
Other
Enumeration date
06/08/2012
Last updated
10/25/2012
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