Individual
CHUKWUNONSO JIDEOFOR AZIKIWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
407 W. STATE HWY 495, SAN JUAN, TX 78589
(956) 383-1111
Mailing address
612 E 59TH ST FL 1, BROOKLYN, NY 11234-1302
(347) 527-0494
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
007490-1
NY
225200000X
Physical Therapy Assistant
Primary
2078690
TX
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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