NPI 1003152620

Laurie Lyn McKittrick

Practitioner Specialist Philadelphia, PA

Practice location

Address: 102 Davis St, Philadelphia, PA 19127-1707
Phone: (856) 904-2908

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 07636646 (PA)

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Registry record

NPI: 1003152620
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Dec 2012
Record last updated: 31 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.