Provider Demographics
NPI:1306190152
Name:MAI, HIEN NGOC (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:HIEN
Middle Name:NGOC
Last Name:MAI
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 ARMITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-6403
Mailing Address - Country:US
Mailing Address - Phone:717-761-6527
Mailing Address - Fax:
Practice Address - Street 1:1205 S 28TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-1046
Practice Address - Country:US
Practice Address - Phone:717-565-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist