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1316091721
GERALD PONCE IGOT
FAIR LAWN, NJ
NPI
1316091721
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40QA00837800)
Enumeration Date
2007-01-22
Last Update Date
2007-07-08
Business Address
Mr. GERALD PONCE IGOT PT
15-01 BROADWAY SUITE30A
FAIR LAWN, NJ 07410-6003
Phone number: 201-703-7107
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Mailing Address
Mr. GERALD PONCE IGOT PT
39-37 WENONAH DR
FAIR LAWN, NJ 07410-5424
Phone number: 201-791-1644
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