CHARLES BOURNE

PHILADELPHIA, PA
NPI1326639642
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: PA  SP021873)
Enumeration Date2021-01-29
Last Update Date2021-01-29
Business Address
CHARLES BOURNE
5528 MORRIS ST
PHILADELPHIA, PA 19144-3807
Phone number: 267-243-9206
Mailing Address
CHARLES BOURNE
5528 MORRIS ST
PHILADELPHIA, PA 19144-3807
Phone number: 267-243-9206
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