Provider Demographics
NPI:1710211875
Name:SANTOS, ELVIS ONG (PT)
Entity type:Individual
Prefix:MR
First Name:ELVIS
Middle Name:ONG
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 S 5TH AVE.
Mailing Address - Street 2:APT. 62
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-3043
Mailing Address - Country:US
Mailing Address - Phone:954-612-2278
Mailing Address - Fax:
Practice Address - Street 1:3325 S 5TH AVE.
Practice Address - Street 2:APT. 62
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-3043
Practice Address - Country:US
Practice Address - Phone:954-612-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist