Doctor Name: | MR. MICHAEL HAUTEA LUCERO |
NPI Number: | 1710182068 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 9853 |
Business Practice Address: | 1000 Salemtowne Dr Winston Salem, NC - 271063294 |
Business Phone Number: | 3367762300 |
Business Fax Number: | |
Mailing Address: | Po Box 1301, CLEMMONS |
State: | NC |
Postal Code: | 270121301 |
Phone Number: | 4787378726 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 9853 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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 |