Individual
MISS ALTHAEA GRACIA SOTELO MADAMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6408 CANNING PL, WAKE FOREST, NC 27587-4266
(919) 453-0793
Mailing address
6408 CANNING PL, WAKE FOREST, NC 27587-4266
(919) 453-0793
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9320
NC
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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