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ProviderCode | Provider Name | Physician ID | Last Name | First Name | Middle Name | TIN # | Specialization | Sub Specialization |
|---|---|---|---|---|---|---|---|---|
'002579 | REABILITY PHYSICAL THERAPY IMUS | '030869 | MARASIGAN | ANGELO | SOLIS | 272204663 | Physical Medicine & Rehabilitation (PM&R) | |
'002579 | REABILITY PHYSICAL THERAPY IMUS | '005199 | PRECILLA | NATHANIEL FRANCIS | GALLARDO | 158931701 | Physical Medicine & Rehabilitation (PM&R) |
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