Individual
JENNY WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2038 WALLACE ST, PHILADELPHIA, PA 19130-3222
(631) 848-0419
Mailing address
2038 WALLACE ST, PHILADELPHIA, PA 19130-3222
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE012446
PA
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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