Individual
SHAVON PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1722 N GRATZ ST, PHILADELPHIA, PA 19121-3113
(267) 634-1479
Mailing address
1722 N GRATZ ST, PHILADELPHIA, PA 19121-3113
(267) 634-1479
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
631442
PA
372600000X
Adult Companion
631442
PR
374U00000X
Home Health Aide
Primary
631442
PA
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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