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General NPI Number Information
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NPI Number | 1710054911
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Entity Type | Individual
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Provider Name | LILLIAN L KWONG MS, PT
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 225 CLEARFIELD AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1815
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Country | US
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Telephone | 757-452-3599
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Fax | 757-961-3696
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Provider Business Mailing Address
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Address Line | 1044 US HIGHWAY 9
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City | PARLIN
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State | NJ
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Zip | 08859-1401
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Country | US
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Telephone | 757-752-1907
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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 | 40QA01414000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305005436
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License Number State | VA
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