Individual
THERESA WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 ALPENA RD, PHILADELPHIA, PA 19115-4511
(267) 388-1806
Mailing address
1020 ALPENA RD, PHILADELPHIA, PA 19115-4511
(267) 388-1806
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN306558
PA
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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