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Individual

CHARLES COFONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 E LANCASTER AVE, STE 650, WYNNEWOOD, PA 19096-3450
(610) 649-8056
Mailing address
61 S ELM AVE, ALDAN, PA 19018-4108
(856) 241-0004

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT013123L
LICENSE #
PA
Enumeration date
08/25/2006
Last updated
07/08/2007
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