Organization
DOUGLASS BREATH OF LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LYDELL DOUGLASS (CERTIFIED RESPIRATORY THERAPIST)
(215) 877-1114
Entity
Organization
Contact information
Practice address
3901 CONSHOHOCKEN AVE, #8308, PHILADELPHIA, PA 19131-5430
(215) 877-1114
(215) 877-1114
Mailing address
3901 CONSHOHOCKEN AVENUE, #8308, PHILADELPHIA, PA 19131
(215) 877-1114
(215) 877-1114
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
YM006253L
PA
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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