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Individual

ELDEBRANDO ORCULLO ESTOMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
186 N MAIN ST, SUITE A, MILLTOWN, NJ 08850-1418
(732) 418-0004
(732) 545-1185
Mailing address
29 PORT MERCER RD, LAWRENCEVILLE, NJ 08648-1341
(609) 520-8647

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00613400
NJ

Other

Enumeration date
05/17/2006
Last updated
07/08/2007
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