Individual
MR. CONRADO TIAMBENG PERALTA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
817 W BRADLEY PL, APT C3, CHICAGO, IL 60613-3934
(269) 281-1119
Mailing address
16089 POPPYSEED CIR, UNIT 2008, DELRAY BEACH, FL 33484-6314
(269) 281-1119
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.018213
IL
225100000X
Physical Therapist
PT 26061
FL
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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