Individual
MARIA PETRONILA TIBUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1202 REDBUD RD, BLACKSBURG, VA 24060-1714
(540) 425-6033
Mailing address
1202 REDBUD RD, BLACKSBURG, VA 24060-1714
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305206548
VA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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