Individual
KATHLEEN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-6698
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA060008
PA
Other
Enumeration date
08/10/2018
Last updated
12/01/2021
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