Individual
EVAN LESSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7564 HAVERFORD AVE, PHILADELPHIA, PA 19151-2112
(215) 878-4636
Mailing address
8573 BENTON ST, PHILADELPHIA, PA 19152-1216
(267) 258-8058
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP449287
PA
Other
Enumeration date
05/08/2015
Last updated
05/08/2015
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