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General NPI Number Information
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NPI Number | 1376665844
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Entity Type | Individual
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Provider Name | ANTOON FRANS VENCKELEER R.P.T.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 35819 RAMADA LANE
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City | YUCAIPA
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State | CA
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Zip | 92399
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Country | US
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Telephone | 909-797-4857
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Fax | 877-768-4674
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Provider Business Mailing Address
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Address Line | 35819 RAMADA LANE
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City | YUCAIPA
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State | CA
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Zip | 92399
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Country | US
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Telephone | 909-797-4857
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Fax | 877-768-4674
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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 | P.T.7946
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License Number State | CA
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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 | PT 7946
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License Number State | CA
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