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General NPI Number Information
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NPI Number | 1912561499
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Entity Type | Individual
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Provider Name | ALICE LIM KONG
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Gender | Female
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 5530 WISCONSIN AVE STE 60
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City | CHEVY CHASE
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State | MD
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Zip | 20815-4404
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Country | US
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Telephone | 301-986-4745
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Fax |
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Provider Business Mailing Address
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Address Line | 14607 ANTIETAM CT
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City | SILVER SPRING
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State | MD
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Zip | 20905-5928
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Country | US
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Telephone | 240-461-6580
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 872576
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License Number State | DC
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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 | 29426
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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