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General NPI Number Information
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NPI Number | 1710184924
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Entity Type | Individual
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Provider Name | JHEFFREY ABRERO PANCHO LPT
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Gender | Male
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | ANNIE PENN NURSING CENTER 618-A SOUTH MAIN STREET
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City | REIDSVILLE
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State | NC
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Zip | 27320
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Country | US
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Telephone | 336-951-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1523 SHERWOOD DR APARTMENT 1
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City | REIDSVILLE
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State | NC
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Zip | 27320-5235
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Country | US
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Telephone | 336-456-8214
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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 | 10779
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License Number State | NC
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