Individual
ANDREW LAWRENCE PONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1860 W WINCHESTER RD STE 108, LIBERTYVILLE, IL 60048-5312
(847) 573-9486
(847) 549-6139
Mailing address
1608 S FALCON DR, LIBERTYVILLE, IL 60048-4212
(224) 294-4250
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
070.027805
IL
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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