Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
May 27, 2006
License(s)
SP008756 (PA), 26NJ00090700 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 34TH AND CIVIC CENTER BOULEVARD 2ND FLOOR, WOOD BUILDING, ORTHOPEDICS | Philadelphia, PA 19104-4399 | 215-590-1527 |
| LOCATION | 34TH AND CIVIC CENTER BOULEVARD 2ND FLOOR, WOOD BUILDING, ORTHOPEDICS | Philadelphia, PA 19104-4399 | 215-590-1527 |
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