Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT010379L | PA |
NPI | 1033449244 |
---|---|
Provider Name | Mrs. Ann Marie Kolongowski-Diaddezio |
First Address | Downingtown, PA 19335-4806 |
Second Address | Wayne, PA 19087-3137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2010 |
Last Update Date | 27/08/2013 |