Individual
LUCY WACHERA KIBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1845 N 23RD ST, PHILADELPHIA, PA 19121-2055
(215) 235-3110
(215) 235-4441
Mailing address
1845 N 23RD ST, PHILADELPHIA, PA 19121-2055
(215) 235-3110
(215) 235-4441
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA056071
PA
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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