Basic Information
| Provider Information | |||||||||
| NPI: | 1912153180 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAPANGAN | ||||||||
| FirstName: | JONAS | ||||||||
| MiddleName: | SAQUILAYAN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10015 OLD COLUMBIA RD | ||||||||
| Address2: | SUITE B-215 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210461703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103566161 | ||||||||
| FaxNumber: | 4103127632 | ||||||||
| Practice Location | |||||||||
| Address1: | 10015 OLD COLUMBIA RD | ||||||||
| Address2: | SUITE B-215 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210461703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103566161 | ||||||||
| FaxNumber: | 4103127632 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 08/07/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 18854 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.