Provider Information for 1215327051
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ALYSSA RENEE KIRK L.P.C.
Sex: Female
NPI: 1215327051
Last Updated: 2016-11-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215327051 | ||||||||
| Enumeration Date | 2015-02-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1401 S 31ST ST 2ND FLOOR PHILADELPHIA, PA 19146-3506 United States Phone: 215-925-2400 | Fax:215-925-9162 | ||||||||
| Primary Practice Address | 4500-10 FRANKFORD AVE 2ND FLOOR PHILADELPHIA, PA 19124 United States Phone: 215-831-9882 | Fax:215-831-9887 | ||||||||
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