Individual
JOHN A LAURY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
3535 MARKET ST STE 100, PHILADELPHIA, PA 19104-3376
(484) 686-0634
Mailing address
1305 SPRUCE ST APT 4A, PHILADELPHIA, PA 19107-5608
(215) 746-3535
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP019276
PA
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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