Individual
CHAD ISAAC BONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC, L.OM
Contact information
Practice address
1618 SOUTH ST, PHILADELPHIA, PA 19146-1542
(267) 210-9877
Mailing address
1618 SOUTH ST, PHILADELPHIA, PA 19146-1542
(267) 210-9877
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
1485
CO
171100000X
Acupuncturist
Primary
OM000089
PA
Other
Enumeration date
11/03/2011
Last updated
12/19/2012
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