Individual
FAWZIAH PIANG MAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
484 MAIN ST, WORCESTER, MA 01608-1893
(508) 751-6321
Mailing address
484 MAIN ST, WORCESTER, MA 01608-1893
(508) 751-6321
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009527
CT
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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