Doctor Name: | EDWARD VELASCO |
NPI Number: | 1750712840 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 3501011383 |
Business Practice Address: | 400 North St W Tawas City, MI - 487639161 |
Business Phone Number: | 9893628647 |
Business Fax Number: | |
Mailing Address: | 4630 Mcnichol Ave, OSCODA |
State: | MI |
Postal Code: | 487501512 |
Phone Number: | 9897393722 |
Fax Number: | |
NPI Enumeration Date: | 11/27/2013 |
NPI Last Update Date: | 11/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 3501011383 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |