Individual
EDISON ANTONIO JR ISADA MARIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0069
MP
Other
Enumeration date
04/04/2024
Last updated
04/08/2024
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