Individual
JIMMY JAIME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-7000
(215) 456-5926
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-7000
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063910
PA
Other
Enumeration date
06/22/2022
Last updated
12/01/2022
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