Individual
GWENDOLYN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6511 VINE ST, PHILADELPHIA, PA 19139-1038
(267) 332-7730
Mailing address
6511 VINE ST, PHILADELPHIA, PA 19139-1038
(267) 332-7730
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
22883601
PA
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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