Individual
LISA MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
(215) 728-4600
Mailing address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN107410L
PA
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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