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NPI Code Detail

MEDICARE: RICHARD GEE-FANG WU PTA

MEDICARE:   RICHARD GEE-FANG WU  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center160.005324IL

General Provider Information

NPI Number : 1215267414
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD GEE-FANG WU PTA
Provider Business Mailing Address
First Line : 6445 N CENTRAL AVE
Second Line : 1ST FLOOR
City : CHICAGO
State : IL
Zip : 60646-2901
Country : US
Telephone Number : 773-594-0225
Fax Number : 773-763-5398
Provider Business Practice Location Address
First Line : 6445 N CENTRAL AVE
Second Line : 1ST FLOOR
City : CHICAGO
State : IL
Zip : 60646-2901
Country : US
Telephone Number : 773-594-0225
Fax Number : 773-763-5398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2010
Last Update Date : 01/11/2010

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Directions to “ RICHARD GEE-FANG WU PTA” Practice Location

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