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General NPI Number Information
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NPI Number | 1992820187
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Entity Type | Organization
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Legal Business Name | SHALOM PHYSICAL THERAPY CORP
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | ROAD 185 KM 4.5
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-484-1408
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1916
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City | CANOVANAS
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State | PR
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Zip | 00729-1916
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Country | US
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Telephone | 787-484-1408
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MRS. IRIS R CASTRO
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Credential | RPT
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Telephone | 787-484-1408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | PR
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