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General NPI Number Information
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NPI Number | 1548516271
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Entity Type | Individual
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Provider Name | ELAINE CRISELDA DEQUINA MOLINE PT
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Gender | Female
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 302 NOTTINGHAM LN
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City | SCHERERVILLE
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State | IN
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Zip | 46375-1809
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Country | US
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Telephone | 561-374-4553
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Fax |
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Provider Business Mailing Address
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Address Line | 16089 POPPYSEED CIR UNIT 2008
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6314
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Country | US
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Telephone |
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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 | 070017788
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License Number State | IL
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