Healthcare Provider Details

I. General information

NPI: 1487621348
Provider Name (Legal Business Name): LEONOR V. JOSEF RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BOX 9095
FPO AP
96538
UM

IV. Provider business mailing address

BOX 9095
FPO AP
96538
UM

V. Phone/Fax

Practice location:
  • Phone: 671-344-9350
  • Fax:
Mailing address:
  • Phone: 671-344-9350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberR1010
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: