Provider Demographics
NPI:1386070217
Name:MIKHAIL, JOANNA (PT)
Entity type:Individual
Prefix:MISS
First Name:JOANNA
Middle Name:
Last Name:MIKHAIL
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:PO BOX 826366
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-6366
Mailing Address - Country:US
Mailing Address - Phone:302-691-5167
Mailing Address - Fax:302-691-5168
Practice Address - Street 1:701 FOULK RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3733
Practice Address - Country:US
Practice Address - Phone:302-691-5167
Practice Address - Fax:302-691-5168
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist