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General NPI Number Information
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NPI Number | 1245676865
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Entity Type | Organization
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Legal Business Name | DONNA M DCIKS-NORMAN
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 2611 S 66TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19142-2802
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Country | US
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Telephone | 215-365-3851
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Fax | 215-365-3861
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Provider Business Mailing Address
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Address Line | 2611 S 66TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19142-2802
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Country | US
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Telephone | 215-365-3851
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Fax | 215-365-3861
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MRS. DONNA M DICKS-NORMAN
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Credential | PHLEBOTOMIST (MA)
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Telephone | 215-365-3851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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