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Individual

GUSTI LICKFIELD STRONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1500 SPRING GARDEN ST SUITE 800, BRAVOHEALTH, PHILADELPHIA, PA 19130
(215) 606-6925
Mailing address
25 MASTERS CIRCLE, MARLTON, NJ 08053
(856) 383-6867

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MBO5791100
NJ
207Q00000X
Family Medicine Physician
H0066773
MD
207Q00000X
Family Medicine Physician
OSO11024L
PA

Other

Enumeration date
04/23/2008
Last updated
04/23/2008
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