Individual
MICHELLE WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-2472
Mailing address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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