Individual
AVA ELIZABETH POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 CONVENTION AVE, PHILADELPHIA, PA 19104-4311
(267) 862-3491
Mailing address
41 BROXTON WAY, GLASSBORO, NJ 08028-2928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA066082
PA
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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