Individual
MR. JEAN E GRAVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
500 OFFICE CENTER DR, SUITE 400, FORT WASHINGTON, PA 19034-3219
(267) 288-8950
Mailing address
500 OFFICE CENTER DR, SUITE 400, FORT WASHINGTON, PA 19034-3219
(267) 288-8950
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296918
PA
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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