Most Relevant Information
Provider Data
| NPI Number: | 1003313438 |
| Provider Name: | LUCAS RYAN PHILIPP |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/11/2018 |
| Last Updated: | 04/11/2018 |
Provider Practice Location
909 WALNUT ST FL 2
PHILADELPHIA
PA
191075211
Practice Location Phone/Fax
| Phone: | 2159557000 |
| Fax: | 2155037038 |
Provider Mailing Location
909 WALNUT ST FL 3
PHILADELPHIA
PA
191075211
Provider Mailing Phone/Fax
| Phone: | 2155037008 |
| Fax: | 2155032452 |