Individual
ALBERTO WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
915 E 5TH ST, ALTON, IL 62002-6434
(618) 463-5259
Mailing address
915 E 5TH ST, ALTON, IL 62002-6434
(618) 463-5259
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070017162
IL
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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