Most Relevant Information
Provider Data
| NPI Number: | 1003337882 |
| Provider Name: | RICHARD A. BETHKE |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/30/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
112 N BROAD ST
PHILADELPHIA
PA
191021512
Practice Location Phone/Fax
| Phone: | 2155680860 |
| Fax: |
Provider Mailing Location
112 N BROAD ST
PHILADELPHIA
PA
191021512
Provider Mailing Phone/Fax
| Phone: | 2155680860 |
| Fax: |