Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Primary Care
Enumerated
Nov 5, 2021
License(s)
SP024729 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 6431 SACKETT ST | Philadelphia, PA 19149 | 267-448-4908 |
| MAILING | 6431 SACKETT ST | Philadelphia, PA 19149 | 267-448-4908 |
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