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1871341073
CRYSTAL ST. FORT
PHILADELPHIA, PA
NPI
1871341073
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207NS0135X Dermatology, Procedural Dermatology
(Licence: PA SP029428)
Enumeration Date
2024-05-11
Last Update Date
2024-05-11
Business Address
CRYSTAL ST. FORT NP
142 S 60TH ST UNIT A
PHILADELPHIA, PA 19139-3038
Phone number: 215-495-5846
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Mailing Address
CRYSTAL ST. FORT NP
142 S 60TH ST UNIT A
PHILADELPHIA, PA 19139-3038
Phone number: 215-495-5846
Copy
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