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1649839077
JASEN TJAHJADI
LANCASTER, PA
NPI
1649839077
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: PA MT217899)
Enumeration Date
2019-06-10
Last Update Date
2019-06-10
Business Address
JASEN TJAHJADI
555 N DUKE ST
LANCASTER, PA 17602-2250
Phone number: 717-544-4940
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Mailing Address
JASEN TJAHJADI
555 N DUKE ST
LANCASTER, PA 17602-2250
Phone number:
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