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1326639642
CHARLES BOURNE
PHILADELPHIA, PA
NPI
1326639642
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: PA SP021873)
Enumeration Date
2021-01-29
Last Update Date
2021-01-29
Business Address
CHARLES BOURNE
5528 MORRIS ST
PHILADELPHIA, PA 19144-3807
Phone number: 267-243-9206
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Mailing Address
CHARLES BOURNE
5528 MORRIS ST
PHILADELPHIA, PA 19144-3807
Phone number: 267-243-9206
Copy
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