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1588126239
TYMIR SHAKEER CLARK
PHILADELPHIA, PA
NPI
1588126239
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: PA pn307634)
Enumeration Date
2019-04-02
Last Update Date
2019-04-02
Business Address
TYMIR SHAKEER CLARK
2219 EDGLEY ST
PHILADELPHIA, PA 19121-1300
Phone number: 267-258-9167
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Mailing Address
TYMIR SHAKEER CLARK
2219 EDGLEY ST
PHILADELPHIA, PA 19121-1300
Phone number:
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