Individual
BROOKLYNN ASHLEY BOULWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1840 SOUTH STREET, 2ND FLOOR, PHILADELPHIA, PA 19146-7422
(215) 893-2240
Mailing address
1840 SOUTH STREET, 2ND FLOOR, PHILADELPHIA, PA 19146-7422
(215) 893-2240
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/05/2021
Last updated
06/08/2023
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