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Organization
MICHAEL WONG PT A PROFESSIONAL CORPORATION
Active
Organization
MICHAEL WONG PT A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL WONG PT (OWNER)
(626) 660-6080
Entity
Organization
Contact information
Practice address
206 E LAS TUNAS DR, SUITE 5, SAN GABRIEL, CA 91776-1411
(626) 660-6080
Mailing address
206 E LAS TUNAS DR, SUITE 5, SAN GABRIEL, CA 91776-1411
(626) 660-6080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT20628
CA
Other
Enumeration date
01/03/2007
Last updated
12/16/2014
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