Doctor Name: | JETRO MANIPES TENERIFE |
NPI Number: | 1356475701 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT 22707 |
Business Practice Address: | 1001 Alabaster Way Ste328 Deltona, FL - 327254324 |
Business Phone Number: | 3862183833 |
Business Fax Number: | |
Mailing Address: | Po Box 1975, ROME |
State: | GA |
Postal Code: | 301621975 |
Phone Number: | 7062048548 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 09/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 22707 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |