Individual
GRACE BENNFORS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
5501 OLD YORK ROAD, KLEIN BUILDING, SUITE 510, PHILADELPHIA, PA 19141
(215) 456-3443
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
LL92785
SC
208600000X
Surgery Physician
Primary
MT235026
PA
Other
Enumeration date
07/31/2023
Last updated
06/25/2025
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