Individual
ALEXANDRA CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC, EMT-B
Contact information
Practice address
1900 W OLNEY AVE, PHILADELPHIA, PA 19141-1108
(215) 951-1519
Mailing address
6204 AVENEL BLVD, NORTH WALES, PA 19454-3959
(484) 716-0593
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
0912212
PA
2255A2300X
Athletic Trainer
Primary
RT008192
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0912212
EMT
PA
Enumeration date
11/08/2021
Last updated
12/05/2024
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