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NPI Code Detail

MEDICARE: MRS. SOPHIAMMA JOBY PHILIP

MEDICARE:  MRS. SOPHIAMMA JOBY PHILIP
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
1225100000XPhysical TherapistIA

General Provider Information

NPI Number : 1760673230
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SOPHIAMMA JOBY PHILIP
Provider Business Mailing Address
First Line : 2314 E MICHAEL MANOR LN
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-4337
Country : US
Telephone Number : 847-797-1992
Fax Number : 847-797-1992
Provider Business Practice Location Address
First Line : 2314 E MICHAEL MANOR LN
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-4337
Country : US
Telephone Number : 847-797-1992
Fax Number : 847-797-1992
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2007
Last Update Date : 08/08/2007

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Directions to “ MRS. SOPHIAMMA JOBY PHILIP ” Practice Location

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