MR. Marciano Funtila Mondala

NPI #1144496928 in Champaign, Illinois

Provider Information

NPI Number: 1144496928
Entity Type: Individual
Name: MR. Marciano Funtila Mondala
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: May 1, 2008
Last Updated: May 1, 2008

Practice Location

Address: 3207 EDWARD HOFFMAN DR
City: Champaign
State: Illinois
ZIP Code: 61822-8018
Phone: (217) 356-8623

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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