Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 7314 | AZ |
NPI | 1003070079 |
---|---|
Provider Name | Eric Biglang-Awa |
First Address | Oakland, CA 94612-3426 |
Second Address | Oakland, CA 94612-3426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2008 |
Last Update Date | 17/07/2008 |