IDRIS RIDDICK

PHILADELPHIA, PA
NPI1528543204
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: PA  PN308356)
Enumeration Date2018-09-28
Last Update Date2018-09-28
Business Address
IDRIS RIDDICK LPN
3872 WYALUSING AVE
PHILADELPHIA, PA 19104-1124
Phone number: 610-679-1723
Mailing Address
IDRIS RIDDICK LPN
3872 WYALUSING AVE
PHILADELPHIA, PA 19104-1124
Phone number: 610-679-1723
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