Individual
JEREMY LINCOLN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1610 MEDICAL DR, SUITE 105, POTTSTOWN, PA 19464-3292
(484) 945-0405
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP012493
PA
Other
Enumeration date
11/06/2012
Last updated
01/27/2017
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