Provider Demographics
NPI:1366638199
Name:ONG, RHODORA (PT)
Entity Type:Individual
Prefix:
First Name:RHODORA
Middle Name:
Last Name:ONG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 NE 35TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-3435
Mailing Address - Country:US
Mailing Address - Phone:253-732-3975
Mailing Address - Fax:
Practice Address - Street 1:501 SE FLOWER MOUND RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-6388
Practice Address - Country:US
Practice Address - Phone:580-351-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10034225100000X
OK4247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist