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General NPI Number Information
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NPI Number | 1497975056
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Entity Type | Individual
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Provider Name | DAVID ALAN VILLASENOR PT
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3550 E FRANK PHILLIPS BLVD JANE PHILLIPS PHYSICAL MEDICINE CENTER
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City | BARTLESVILLE
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State | OK
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Zip | 74006-2411
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Country | US
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Telephone | 918-331-1594
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Fax | 918-331-1631
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Provider Business Mailing Address
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Address Line | 1207 MAY LN
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City | BARTLESVILLE
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State | OK
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Zip | 74006-5628
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Country | US
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Telephone | 918-333-5145
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Fax |
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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 | 766
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License Number State | OK
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