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NPI Code Detail

MEDICARE: JUNWYN THOMAS VALDEZ AGUSTIN PT

MEDICARE:   JUNWYN THOMAS VALDEZ AGUSTIN  PT
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 Therapist3057NV

General Provider Information

NPI Number : 1821492778
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUNWYN THOMAS VALDEZ AGUSTIN PT
Provider Business Mailing Address
First Line : 6028 LAMBERT BRIDGE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-7589
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6028 LAMBERT BRIDGE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-7589
Country : US
Telephone Number : 586-381-8315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2014
Last Update Date : 07/21/2015

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Directions to “ JUNWYN THOMAS VALDEZ AGUSTIN PT” Practice Location

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