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General NPI Number Information
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NPI Number | 1376816769
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY-ORTHO REHAB
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Dates
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Enumeration Date | 02/15/2012
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | ESCUELA DE MEDICINA 1575 AVE. MUNOZ RIVERA
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City | PONCE
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State | PR
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Zip | 00717
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Country | US
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Telephone | 787-455-7824
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Fax |
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Provider Business Mailing Address
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Address Line | HC 03 BOX 14390
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-455-7824
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Fax |
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Authorized Official
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Title or Position | LCDA
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Name | MARIA C. CASINAO
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Credential |
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Telephone | 787-455-7824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1109
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License Number State | PR
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