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Individual

MRS. EVANGELINE Q LAXAMANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPT

Contact information

Practice address
385 PROSPECT AVE, HACKENSACK, NJ 07601-2570
(201) 968-0303
(201) 968-0330
Mailing address
385 PROSPECT AVE, HACKENSACK, NJ 07601-2570
(201) 968-0303
(201) 968-0330

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01154700
NJ

Other

Enumeration date
07/11/2006
Last updated
07/08/2007
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