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Organization
PROHEALTH LEADERS LLC
Active
Organization
PROHEALTH LEADERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITHA GEORGE CRNP (MEMBER)
(215) 464-2753
Entity
Organization
Contact information
Practice address
9963 BUSTLETON AVE, PHILADELPHIA, PA 19115-1557
(215) 464-2753
(215) 464-4738
Mailing address
9715 JEANES ST, PHILADELPHIA, PA 19115-1901
(215) 464-2753
(215) 464-4738
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/21/2017
Last updated
01/13/2020
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