MRS. Materesita Ayuban Antonsson, PHYSICAL THERAPIST
NPI #1164632436 in Bloomfield, New Jersey
Provider Information
- NPI Number
- 1164632436
- Entity Type
- Individual
- Name
- MRS. Materesita Ayuban Antonsson, PHYSICAL THERAPIST
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapist
- Credential
- PHYSICAL THERAPIST
- Enumeration Date
- May 23, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 267 SPRUCE ST
- City
- Bloomfield
- State
- New Jersey
- ZIP Code
- 07003-3645
- Phone
- (973) 748-9578
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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