HEALTHY AGING CLINIC NPI 1104171206

NPI Information

HEALTHY AGING CLINIC is an adult medicine family medicine in Milford, DE. The provider is definition to come. HEALTHY AGING CLINIC NPI is 1104171206. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1014 NORTH WALNUT STREET
MILFORD, DE
ZIP 19963-244
Phone: (302) 422-5700
Fax: (302) 424-8018

The provider's authorized official is Eugene E. Godfrey .
The authorized official title is Physician and has the following contact phone number (302) 422-5700.

The enumeration date for this NPI number is 7/16/2012 and was last updated on 7/16/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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