JESSE PHALANUKORN

BRICK, NJ
NPI1407455199
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: WA  PT61209291)
Enumeration Date2020-10-22
Last Update Date2021-10-21
Business Address
JESSE PHALANUKORN
489 BRICK BLVD
BRICK, NJ 08723-6055
Phone number: 732-895-7283
Mailing Address
JESSE PHALANUKORN
489 BRICK BLVD
BRICK, NJ 08723-6055
Phone number: 732-895-7283