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NPI Code Detail

MEDICARE: MR. ARIEL YABUT APARENTADO RPT

MEDICARE: MR. ARIEL YABUT APARENTADO RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251G0304XGeriatric Physical Therapist2006022059MO
22251G0304XGeriatric Physical TherapistIL

General Provider Information

NPI Number : 1962621854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ARIEL YABUT APARENTADO RPT
Provider Business Mailing Address
First Line : 214 W 5TH ST
Second Line : SUITES D & E
City : JOPLIN
State : MO
Zip : 64801-2501
Country : US
Telephone Number : 417-827-8069
Fax Number :
Provider Business Practice Location Address
First Line : 1701 N BOWMAN AVENUE RD
Second Line :
City : DANVILLE
State : IL
Zip : 61832-2200
Country : US
Telephone Number : 217-443-2955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 07/08/2007

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