Individual
MR. MUSTAFA MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NONE
Contact information
Practice address
1815 72ND AVE, PHILADELPHIA, PA 19126-1512
(215) 552-1124
Mailing address
1815 72ND AVE, PHILADELPHIA, PA 19126-1512
(215) 552-1124
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
48913601
PA
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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