Individual
ALEXA MARIE TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
330 JACKSONVILLE RD APT 8-311, WARMINSTER, PA 18974-6411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA065799
PA
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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