Individual
ALLEN LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1443 S 7TH ST, PHILADELPHIA, PA 19147-5847
(215) 463-7748
Mailing address
611 MORRIS ST, PHILADELPHIA, PA 19148-1201
(267) 237-4412
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP452622
PA
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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