Healthcare Provider Details

I. General information

NPI: 1255651014
Provider Name (Legal Business Name): VERONICA VANESSA ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 W ELM AVE
MONROE MI
48162-7909
US

IV. Provider business mailing address

610 W ELM AVE
MONROE MI
48162-7909
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-9670
  • Fax:
Mailing address:
  • Phone: 734-240-9670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberL1671985
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: