Individual
JUSTIN LUU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6161
Mailing address
111 S 11TH ST STE 8490, PHILADELPHIA, PA 19107-4824
(215) 923-5507
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN640413
PA
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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