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MR. ANTONIO EACDINE POMPONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT CERT MDT

Contact information

Practice address
52 RISING SUN TOWN CTR, RISING SUN, MD 21911-1902
(410) 658-0100
(410) 658-0199
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19990
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2866484000
IBC AMERIHEALTH
01
P00419671
RR MEDICARE
Enumeration date
08/15/2006
Last updated
12/20/2013
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