Individual
THOMAS DUDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
(215) 546-5960
Mailing address
1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
(215) 546-5960
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0001504
DE
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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