Individual
MR. JEFFREY TODD WIMBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 N BROAD ST, PHILA, PA 19102-1510
(215) 568-0860
(215) 568-0769
Mailing address
1546 S 19TH ST, PHILA, PA 19146-4616
(215) 463-7136
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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