Individual
CHRIS FARNSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1113 ALEXANDER AVE, DREXEL HILL, PA 19026-4201
(484) 995-1457
Mailing address
1113 ALEXANDER AVE, DREXEL HILL, PA 19026-4201
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP002984L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
QCH121028785001
KEYSTONE
PA
Enumeration date
11/27/2018
Last updated
11/27/2018
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