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Tyreesah Lashae Wilkerson-cobb
Prosthetic/Orthotic Supplier in Philadelphia, Pennsylvania
NPI 1750098760

Tyreesah Lashae Wilkerson-cobb is a Prosthetic/Orthotic Supplier based in Philadelphia, PA. Tyreesah Lashae Wilkerson-cobb practices in Philadelphia, PA. The NPI Number for Tyreesah Lashae Wilkerson-cobb is 1750098760 and holds a License No. 807950 (Pennsylvania).

The current practice location address for Tyreesah Lashae Wilkerson-cobb is 5613 Master St, Philadelphia, PA and can be reached out via phone at 215-820-8073.

Location: 5613 Master St, Philadelphia, PA, 19131-3833
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750098760
Provider Name
Tyreesah Lashae Wilkerson-cobb
Credential
Provider Entity Type
Individual
Gender
Female
Address
5613 Master St, Philadelphia, PA, 19131-3833
Phone Number
215-820-8073
Fax Number
Provider Enumeration Date
10/31/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5613 Master St
City
Philadelphia
State
Pennsylvania
Zip
19131-3833
Phone Number
215-820-8073
Fax Number
person
Provider Business Mailing Address Details
Address
5613 Master St
City
Philadelphia
State
Pennsylvania
Zip
19131-3833
Phone Number
215-820-8073
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
807950 (Pennsylvania)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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