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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. EDWARD LEE PONCE, PT

Active

MR. EDWARD LEE PONCE, PT is a Physical Medicine & Rehabilitation healthcare provider located in BLOOMINGTON, Illinois. NPI 1528176138 is currently active in the NPPES registry. Verify at CMS.

Physical Medicine & Rehabilitation · BLOOMINGTON, IL

Registration Details

NPI Number
1528176138
Provider Type
Individual
Gender
Male
NPI Issued
Aug 25, 2006 (20.016055261635 yrs)
Last Updated
Jan 4, 2018
Licenses
070010014 (IL)
070-010014 (IL)

Practice Information

Address
1111 TRINITY LN STE 111
BLOOMINGTON, IL, 617048112
Browse IL providers · Browse ZIP 61704
Phone
3096636461
Fax
3096635711
Primary Specialty
Physical Medicine & Rehabilitation
208100000X

Other Physical Medicine & Rehabilitation Providers in BLOOMINGTON, IL

Name Credential NPI
DR. NENITA C TUDTUD M.D. 1639105034
WON JHEE 1861411027
DR. CRAIG W CARMICHAEL M.D. 1497761100
MRS. SARA ALINE FRANCOIS PT 1174015010
JENNIFER MARIE HAIR PTA 1881277358
MADISON MITCHELL PTA 1922813609
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.