Doctor Name: | MARIA VICTORIA VELOSO CUSTODIO |
NPI Number: | 1518233980 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 070017083 |
Business Practice Address: | 12550 S Ridgeland Ave Genesis-park Villa Palos Heights, IL - 604631859 |
Business Phone Number: | 7085979300 |
Business Fax Number: | |
Mailing Address: | 12550 S Ridgeland Ave, Genesis-park Villa PALOS HEIGHTS |
State: | IL |
Postal Code: | 604631859 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/29/2012 |
NPI Last Update Date: | 03/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070017083 |
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 |