Individual
JACOB ALEXANDER WENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7600 CENTRAL AVE, PHILADELPHIA, PA 19111-2442
(215) 728-2273
Mailing address
7600 CENTRAL AVE, PHILADELPHIA, PA 19111-2442
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA065150
PA
Other
Enumeration date
11/10/2023
Last updated
08/26/2024
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