Organization
OLIVE BRANCH MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORETTA F BROWN D.O. (OWNER)
(215) 200-3913
Entity
Organization
Contact information
Practice address
2 BALA PLZ STE 50, BALA CYNWYD, PA 19004-1501
(215) 200-3913
Mailing address
5427 WAYNE AVE APT G22, PHILADELPHIA, PA 19144-3455
(215) 200-3913
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS004959L
PA
261Q00000X
Clinic/Center
Primary
OS004959L
PA
Other
Enumeration date
11/12/2014
Last updated
09/28/2015
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