Individual
MA DOLOR VILLACASTIN ONGTAWCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
12654 CASTETTER CT, FISHERS, IN 46038-1081
(317) 640-2655
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05003095A
IN
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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