Individual
JAMIE JOANNE LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2400 MARYLAND RD, SUITE 20, WILLOW GROVE, PA 19090
(215) 830-8700
(215) 830-8715
Mailing address
833 CHESTNUT ST STE 520, PHILADELPHIA, PA 19107-4414
(215) 830-8700
(267) 339-3761
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA056248
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA056248
STATE LICENSURE
PA
Enumeration date
07/17/2013
Last updated
08/23/2018
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