Individual
MS. PAMELA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1930 S BROAD ST, PHILADELPHIA, PA 19145-2328
(215) 339-4563
Mailing address
1606 S CORLIES ST, PHILADELPHIA, PA 19145-1662
(215) 336-0429
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN262115
PA
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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