Individual
MR. CHARLES BONGCAWEL MUTIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPY
Contact information
Practice address
421 W WINDSOR RD APT 5, GLENDALE, CA 91204-1945
(818) 551-9973
Mailing address
421 W WINDSOR RD APT 5, GLENDALE, CA 91204-1945
(818) 551-9973
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
AT 6559
CA
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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