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NPI Code Detail

MEDICARE: ELAINA IAZZETTI VALLO MSPT

MEDICARE:   ELAINA IAZZETTI VALLO  MSPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1143568TX

General Provider Information

NPI Number : 1134454895
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELAINA IAZZETTI VALLO MSPT
Provider Business Mailing Address
First Line : 11614 BEE CAVES RD
Second Line : SUITE 160
City : AUSTIN
State : TX
Zip : 78738-5405
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11614 BEE CAVES RD
Second Line : SUITE 160
City : AUSTIN
State : TX
Zip : 78738-5405
Country : US
Telephone Number : 512-428-4261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2009
Last Update Date : 10/13/2009

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Directions to “ ELAINA IAZZETTI VALLO MSPT” Practice Location

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