Individual
SELERIA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 TOWNSHIP LINE RD STE 102, DREXEL HILL, PA 19026-1925
(610) 853-9919
Mailing address
3300 TOWNSHIP LINE RD STE 102, DREXEL HILL, PA 19026-1925
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
SL007049
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020095360001
—
PA
Enumeration date
01/14/2008
Last updated
01/14/2008
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