Individual
MRS. BERNADETTE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
715 S ITHAN ST, PHILADELPHIA, PA 19143-2809
(215) 833-1417
(215) 463-4762
Mailing address
1450 POINT BREEZE AVE, PHILADELPHIA, PA 19146-4522
(215) 833-1417
(215) 463-4762
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
10/26/2012
Last updated
10/26/2012
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