Individual
TIA UPCHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8460 LIMEKILN PIKE APT 804, WYNCOTE, PA 19095-2609
(215) 847-4003
Mailing address
8460 LIMEKILN PIKE APT 804, WYNCOTE, PA 19095-2609
(215) 847-4003
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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