Mondala, Marciano Funtila
Mondala, Marciano Funtila is an sole proprietor health care provider with primary practice located at 3207 Edward Hoffman Dr , Champaign IL 61822-8018. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Mondala, Marciano Funtila can be contacted via phone (217) 356-8623.Contact Information
Primary practice address
3207 Edward Hoffman Dr
Champaign IL 61822-8018
Phone: (217) 356-8623
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 070013083 | Illinois |
Profile Details
| NPI number | 1144496928 |
|---|---|
| LBN Legal business name | Mondala, Marciano Funtila |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 1st, 2008 |
| Last updated | May 1st, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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