Individual
MIA SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
600 EVERGREEN DR STE 201, GLEN MILLS, PA 19342-1053
(800) 321-9999
(267) 479-1321
Mailing address
833 CHESTNUT ST STE 520, PHILADELPHIA, PA 19107-4430
(267) 339-7843
(267) 339-3761
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
25MB11516200
NJ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS021654
PA
Other
Enumeration date
06/04/2018
Last updated
06/27/2025
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