Individual
MRS. CARLINE FOMBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT/DPT
Contact information
Practice address
4560 SE INTERNATIONAL WAY, STE 100, MILWAUKIE, OR 97222-4628
(971) 206-2314
Mailing address
27W011 LINDSEY AVE, WINFIELD, IL 60190-2113
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-011484
IL
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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