Individual
LUWAN TEKLE WELDESELASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7144 GUYER AVE, PHILADELPHIA, PA 19153-2406
(202) 509-3080
Mailing address
7144 GUYER AVE, PHILADELPHIA, PA 19153-2406
(202) 509-3080
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
MWG5335
PA
Other
Enumeration date
04/21/2025
Last updated
12/04/2025
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