| Organization Name: | OVATION CENTER OF INTEGRATIVE MEDICINE UBO |
| NPI Number: | 1356713853 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RON SISCOE (OWNER) |
| Mailing Address: | 1825 Limekiln Pike Suite 5 Dresher |
| State: | PA US |
| Postal Code: | 190251739 |
| Phone Number: | 2156466400 |
| Fax Number: | 2156460650 |
| NPI Enumeration Date: | 10/22/2015 |
| NPI Last Update Date: | 01/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |