Individual
RAUL ASIS ITCHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
600 W VALLEY FORGE RD, KING OF PRUSSIA, PA 19406-1571
(610) 337-1775
Mailing address
275 SWEDESFORD RD, MALVERN, PA 19355-1658
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE001802L
PA
Other
Enumeration date
10/03/2008
Last updated
11/04/2008
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