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General NPI Number Information
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NPI Number | 1558902510
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Entity Type | Individual
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Provider Name | JUAN CAMILO PAZ DELGADO DPT
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Gender | Male
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 5200 W 94TH TER STE 112
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66207-2534
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Country | US
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Telephone | 913-224-2990
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Fax | 913-224-2992
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Provider Business Mailing Address
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Address Line | PO BOX 5105
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City | BELFAST
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State | ME
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Zip | 04915-5100
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Country | US
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Telephone | 103-323-8009
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Fax | 910-251-0421
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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 | 1106327
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License Number State | KS
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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 | 2019030127
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP029705T
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License Number State | NC
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