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Individual

MARIO NINO CAPITULO UMALI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
3290 N RIDGE RD, SUITE 290, ELLICOTT CITY, MD 21043-3655
(410) 750-9006
(410) 750-0787
Mailing address
3290 N RIDGE RD, SUITE 290, ELLICOTT CITY, MD 21043-3655
(410) 750-9006
(410) 750-0787

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015430
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070015430
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
12/08/2008
Last updated
12/08/2008
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