| Radiance Therapy Group | |
|
1601 Walnut St Ste 1005 Philadelphia PA 19102-2906 | |
| (484) 868-6350 | |
| Not Available |
| Full Name | Radiance Therapy Group |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1601 Walnut St Ste 1005, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Andrew Defino (OWNER) |
| Authorized Official Contact | 2158471690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiance Therapy Group 2405 South St Philadelphia PA 19146-1035 Ph: () - | Radiance Therapy Group 1601 Walnut St Ste 1005 Philadelphia PA 19102-2906 Ph: (484) 868-6350 |
| NPI Number | 1194559971 |
|---|---|
| Provider Enumeration Date | 08/26/2024 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194559971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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