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NPI Code Detail

MEDICARE: MRS. FARLI JEAN UY NOVAL PT

MEDICARE: MRS. FARLI JEAN UY NOVAL 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 Therapist050072650IN

General Provider Information

NPI Number : 1902052517
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FARLI JEAN UY NOVAL PT
Provider Business Mailing Address
First Line : 2222 MARGARET AVE
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-3339
Country : US
Telephone Number : 812-231-4527
Fax Number :
Provider Business Practice Location Address
First Line : 2222 MARGARET AVE
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-3339
Country : US
Telephone Number : 812-231-4527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2008
Last Update Date : 08/14/2008

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