ALEX BONGON SIAPNO

SMYRNA, DE
NPI1891056529
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: DE  J1-0002773)
Additional Taxonomies225100000X Physical Therapist
(Licence: TX  1215510)
Enumeration Date2012-05-29
Last Update Date2012-05-29
Business Address
-- ALEX BONGON SIAPNO P.T.
3034 S DUPONT BLVD.
SMYRNA, DE 19977
Phone number: 302-653-5085
Mailing Address
-- ALEX BONGON SIAPNO P.T.
11 FAIRWAY LAKES DR APT. E21
DOVER, DE 19904-8266
Phone number: 305-793-0568
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