Individual
TRACY IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
3347A MONTROSE AVE, LAURELDALE, PA 19605-2213
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
9504065
PA
Other
Enumeration date
09/26/2008
Last updated
09/26/2008
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