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General NPI Number Information
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NPI Number | 1629047063
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Entity Type | Individual
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Provider Name | MR. ARNOLD E VILLAVICENCIO
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5431 MAIN ST
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City | KANSAS CITY
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State | MO
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Zip | 64112-2823
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Country | US
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Telephone | 816-523-5334
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 EATON STREET
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City | KANSAS CITY
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State | KS
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Zip | 66103
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Country | US
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Telephone | 913-236-8048
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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 | R0948
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License Number State | MO
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