Individual
DR. CHRISTIE O MOUSAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
300 EVERGREEN DR, SUITE 310, GLEN MILLS, PA 19342-1059
(610) 579-3564
(610) 579-3566
Mailing address
300 EVERGREEN DR, SUITE 310, GLEN MILLS, PA 19342-1059
(610) 579-3555
(610) 579-3566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS 012760
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101720742
—
PA
Enumeration date
09/20/2006
Last updated
07/08/2014
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