Doctor Name: | JOHNES MARCERA FLORES |
NPI Number: | 1104000215 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 070-015529 |
Business Practice Address: | 2081 N Main St Canton, IL - 615201032 |
Business Phone Number: | 3096476135 |
Business Fax Number: | |
Mailing Address: | 100 Longwood Dr, CANTON |
State: | IL |
Postal Code: | 615201205 |
Phone Number: | 3093570863 |
Fax Number: | |
NPI Enumeration Date: | 12/26/2007 |
NPI Last Update Date: | 11/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070-015529 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |