Individual
THOMAS TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2250 HICKORY RD, STE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
2303 SOLLY AVE, PHILADELPHIA, PA 19152-2912
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN254024L
PA
Other
Enumeration date
02/05/2008
Last updated
02/05/2008
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