Individual
DR. KOURA SALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5189
(800) 836-7536
Mailing address
1716 WALLACE ST APT 202, PHILADELPHIA, PA 19130-4302
(918) 850-4807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OT021855
PA
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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