Individual
THOMAS COMMANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PN045890L
Contact information
Practice address
6636 PERRY AVE, UPPER DARBY, PA 19082-4311
(610) 734-1175
Mailing address
6636 PERRY AVE, UPPER DARBY, PA 19082-4311
(610) 734-1175
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN045890L
PA
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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