NPI 1750098760

Tyreesah Lashae Wilkerson-Cobb

Practitioner Prosthetic/Orthotic Supplier Philadelphia, PA

Practice location

Address: 5613 Master St, Philadelphia, PA 19131-3833
Phone: (215) 820-8073

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X Licence 807950 (PA)

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Registry record

NPI: 1750098760
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Oct 2022
Record last updated: 31 Oct 2022

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.