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Individual

GREGORY LAURIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2250 HICKORY ROAD, SUITE 240, PLYMOUTH MEETING, PA 19462
(610) 834-1122
(610) 834-7525
Mailing address
8111 FORREST AVENUE, PHILADELPHIA, PA 19150
(215) 248-4127

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN069778L
PA

Other

Enumeration date
05/02/2007
Last updated
07/08/2007
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