Individual
BARRY HARVEY WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1710 N FERN ST, ORANGE, CA 92867-4061
(949) 276-1276
Mailing address
1710 N FERN ST, ORANGE, CA 92867-4061
(949) 276-1276
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT13997
CA
2251S0007X
Sports Physical Therapist
PT13997
CA
2251X0800X
Orthopedic Physical Therapist
PT13997
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT13997
PT LICENSE#
CA
Enumeration date
06/06/2007
Last updated
10/28/2014
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