Individual
BEVERLEY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6145 MORTON ST, PHILADELPHIA, PA 19144-1002
(267) 632-1720
Mailing address
6145 MORTON ST, PHILADELPHIA, PA 19144-1002
(267) 632-1720
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2481
—
PA
05
—
83-3656349
—
PA
Enumeration date
02/10/2020
Last updated
02/10/2020
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