Individual
JIBIN JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 CHURCH ST, PHILADELPHIA, PA 19106-2201
(844) 459-7589
Mailing address
110 CHURCH ST, PHILADELPHIA, PA 19106-2201
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
08/22/2017
Last updated
10/04/2024
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