Healthcare Provider Details

I. General information

NPI: 1689919250
Provider Name (Legal Business Name): WESTERN INTEGRATED THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HACIENDAS DE CABO ROJO 3112 CALLE PALMERAS
CABO ROJO PR
00623
US

IV. Provider business mailing address

PO BOX 911
CABO ROJO PR
00623-0911
US

V. Phone/Fax

Practice location:
  • Phone: 939-630-1881
  • Fax:
Mailing address:
  • Phone: 939-630-1881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. NORMA J ARCINIEGAS-MEDINA
Title or Position: PRESIDENT
Credential: MD
Phone: 939-630-1881