Individual
MR. IAN PANELO AGUINALDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, MSPT
Contact information
Practice address
6 E SHAWNEE DR, MURPHYSBORO, IL 62966-7048
(618) 684-8018
Mailing address
211 WILDROSE LN APT B, MARION, IL 62959-1216
(618) 751-2466
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.021846
IL
225100000X
Physical Therapist
294711
CA
225100000X
Physical Therapist
PT34228
FL
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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