Doctor Name: | JOAN LUNA VICENTE |
NPI Number: | 1003005414 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 5501012517 |
Business Practice Address: | 4560 Se International Way Consonus Healthcare Services Suite 100 Milwaukie, OR - 97222 |
Business Phone Number: | 9712065149 |
Business Fax Number: | 9712065209 |
Mailing Address: | 4560 Se International Way, Consonus Healthcare Services Suite 100 MILWAUKIE |
State: | OR |
Postal Code: | 97222 |
Phone Number: | 9712065149 |
Fax Number: | 9712065209 |
NPI Enumeration Date: | 10/22/2007 |
NPI Last Update Date: | 10/22/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501012517 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |