Individual
CALVIN JIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9815 ROOSEVELT BLVD, PHILADELPHIA, PA 19114-1035
(215) 677-8200
Mailing address
10230 MURTY LN, PHILADELPHIA, PA 19116-3765
(267) 815-3376
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC018714
PA
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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