Most Relevant Information
Provider Data
| NPI Number: | 1003397175 |
| Provider Name: | NADIA ANGELIQUE DUMALASA IMPERIAL |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/27/2018 |
| Last Updated: | 08/27/2018 |
Provider Practice Location
150 GIBSON RD
ATHENS
TX
757515611
Practice Location Phone/Fax
| Phone: | 9036775864 |
| Fax: |
Provider Mailing Location
150 GIBSON RD
ATHENS
TX
757515611
Provider Mailing Phone/Fax
| Phone: | 9036775864 |
| Fax: |