Individual
ALFEA MARIE MORENO BONGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
810 S BROOM ST, WILMINGTON, DE 19805-4245
(302) 652-1181
Mailing address
104 BUCKSON CT, BEAR, DE 19701-3056
(310) 866-7276
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0001068
DE
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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