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General NPI Number Information
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NPI Number | 1255899175
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Entity Type | Individual
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Provider Name | ONYEDIKACHI UGWU
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Gender | Male
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Dates
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Enumeration Date | 03/10/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1130 N LOOP 340
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City | LACY LAKEVIEW
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State | TX
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Zip | 76705-2400
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Country | US
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Telephone | 682-802-9986
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Fax |
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Provider Business Mailing Address
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Address Line | 1728 MAPLE ST
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City | MCKEESPORT
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State | PA
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Zip | 15132-5335
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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