MEDICARE: MR. WING HONG KAI P.T.

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
1	225100000X	Physical Therapist	05002062A	IN

General Provider Information

NPI Number	:	1790707693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WING HONG KAI P.T.

Provider Business Mailing Address
First Line	:	2419 EISENHOWER ST
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-3282
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9250 COLUMBIA AVE
Second Line	:	SUITE F-1
City	:	MUNSTER
State	:	IN
Zip	:	46321-3538
Country	:	US
Telephone Number	:	219-836-4921
Fax Number	:	219-836-4923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	07/08/2007

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