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General NPI Number Information
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NPI Number | 1962736496
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Entity Type | Individual
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Provider Name | ALVIN ANGCANAN P.T.
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Gender | Male
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 106 WESTWOOD CMN
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City | BLUEFIELD
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State | VA
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Zip | 24605-2031
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Country | US
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Telephone | 276-322-2599
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Fax |
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Provider Business Mailing Address
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Address Line | 304 WEST ST
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City | TAZEWELL
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State | VA
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Zip | 24651-9775
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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 | 2305006164
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License Number State | VA
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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 | 3944
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License Number State | TN
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