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NPI 1033304480

NPI 1033304480 : VIRGIE LOMBOY PEREZ PT : COLUMBIA, SC

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General NPI Number Information
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    NPI Number           |    1033304480
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    Entity Type          |    Individual 
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    Provider Name        |    VIRGIE LOMBOY PEREZ PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/10/2007
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    Last Update Date     |    03/20/2019
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Provider Practice Location Address
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    Address Line         |    322 ALLANS MILL DR 
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    City                 |    COLUMBIA
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    State                |    SC
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    Zip                  |    29223-4269
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    Country              |    US
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    Telephone            |    309-255-9207
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    Fax                  |    855-232-8604
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Provider Business Mailing Address
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    Address Line         |    322 ALLANS MILL DR 
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    City                 |    COLUMBIA
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    State                |    SC
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    Zip                  |    29223-4269
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    Country              |    US
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    Telephone            |    309-255-9207
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    Fax                  |    855-232-8604
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    70015292
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    7811
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    License Number State |    SC
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