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NPI Code Detail

MEDICARE: MRS. MARIA GLORIA PADOR BUENCONSEJO P.T.

MEDICARE:  MRS. MARIA GLORIA PADOR BUENCONSEJO  P.T.
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 Therapist05002590IN

General Provider Information

NPI Number : 1487862744
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIA GLORIA PADOR BUENCONSEJO P.T.
Provider Business Mailing Address
First Line : 9319 WATERS CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-7008
Country : US
Telephone Number : 260-489-3016
Fax Number :
Provider Business Practice Location Address
First Line : 9319 WATERS CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-7008
Country : US
Telephone Number : 260-489-3016
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2007
Last Update Date : 07/09/2007

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Directions to “ MRS. MARIA GLORIA PADOR BUENCONSEJO P.T.” Practice Location

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