Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Dec 30, 2014
License(s)
SP014568 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 5501 OLD YORK RD KORMAN BUILDING-SUITE 202 | Philadelphia, PA 19141-3018 | 215-456-6990 |
| LOCATION | 5501 OLD YORK RD KLEIN BUILDING-SUITE 410 | Philadelphia, PA 19141-3018 | 215-456-6990 |
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