Healthcare Provider Details

I. General information

NPI: 1831413434
Provider Name (Legal Business Name): SERVICIOS DE TERAPIA FISICA AIC, CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CALLE RAFAEL ARROYO RIOS S
HUMACAO PR
00791-3932
US

IV. Provider business mailing address

PO BOX 9030
HUMACAO PR
00792-9030
US

V. Phone/Fax

Practice location:
  • Phone: 787-850-1337
  • Fax: 787-850-1337
Mailing address:
  • Phone: 787-850-1337
  • Fax: 787-850-1337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number776
License Number StatePR

VIII. Authorized Official

Name: ADA I COLON
Title or Position: ADMINISTRADORA
Credential: PT, MPT
Phone: 787-850-1337