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Individual

ALEX BONGON SIAPNO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
3034 S DUPONT BLVD., SMYRNA, DE 19977
(302) 653-5085
Mailing address
11 FAIRWAY LAKES DR, APT. E21, DOVER, DE 19904-8266
(305) 793-0568

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1215510
TX
225100000X
Physical Therapist
Primary
J1-0002773
DE

Other

Enumeration date
05/29/2012
Last updated
05/29/2012
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