Individual
MR. PERCY JUNIOR MCKITTHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
5353 LINDBERGH BLVD, PHILADELPHIA, PA 19143-5829
(267) 770-2878
Mailing address
6445 N BROAD ST, APT 1, PHILADELPHIA, PA 19126-3626
(267) 221-8713
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
3269676
PA
Other
Enumeration date
03/05/2013
Last updated
03/05/2013
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