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Individual

MISS AMBER ZEIGLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
702 N 3RD ST, PMB 770, PHILADELPHIA, PA 19123-2904
(267) 761-9998
Mailing address
702 N 3RD ST, PMB 770, PHILADELPHIA, PA 19123-2904

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
640899
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16747680
NATIONAL PRODUCER NUMBER
01
53057
FFM #
PA
Enumeration date
10/05/2016
Last updated
10/05/2016
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