Organization
LIVING INDEPENDENTLY FOR ELDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. GWEN LECH (NURSE PRACTITIONER)
(215) 386-1094
Entity
Organization
Contact information
Practice address
4508 CHESTNUT ST, PHILA, PA 19139-3608
(215) 573-7200
Mailing address
4508 CHESTNUT ST, PHILA, PA 19139-3608
(215) 573-7200
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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