JUSTIN EGOVILLE

PHILADELPHIA, PA
NPI1336410851
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: PA  SP011762)
Enumeration Date2012-01-13
Last Update Date2012-01-13
Business Address
-- JUSTIN EGOVILLE NP
80001 STATE RD. MHM CORRECTIONAL SERVICES, MOD II
PHILADELPHIA, PA 19136-0000
Phone number: 215-624-0797
Mailing Address
-- JUSTIN EGOVILLE NP
257 WINDING WAY
MERION STATION, PA 19066-1225
Phone number: 610-668-9528
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