Individual
JOSEPH SO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
169 W CHEW AVE, PHILADELPHIA, PA 19120-2454
(215) 983-0635
Mailing address
111 N 9TH ST, PHILADELPHIA, PA 19107-2460
(215) 983-0635
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT022052
PA
Other
Enumeration date
08/31/2012
Last updated
09/11/2015
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