Individual
JARED WILSON LUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 OFFICE CENTER DR STE 195, FORT WASHINGTON, PA 19034-3268
(215) 836-7900
(215) 836-7923
Mailing address
501 OFFICE CENTER DR STE 195, FORT WASHINGTON, PA 19034-3268
(215) 836-7900
(215) 836-7923
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA060528
PA
Other
Enumeration date
03/06/2019
Last updated
11/05/2020
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