Individual
MISS MILDRED MAGSANOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
114 HAYES MILL RD, ATCO, NJ 08004-2457
(856) 809-7242
Mailing address
26 BROOKSTONE DR, SICKLERVILLE, NJ 08081-1692
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
40QAOO730900
NJ
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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