ANTHONY KHUNTONG PANBAMRUNG

FORT WAYNE, IN
NPI1861699092
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IN  06002861A)
Enumeration Date2007-06-29
Last Update Date2007-07-08
Business Address
Mr. ANTHONY KHUNTONG PANBAMRUNG PTA
2827 NORTHGATE BLVD
FORT WAYNE, IN 46835-2903
Phone number: 260-492-1498
Mailing Address
Mr. ANTHONY KHUNTONG PANBAMRUNG PTA
3516 UTAH DR
FORT WAYNE, IN 46815-6640
Phone number: 260-385-3517
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