Doctor Name: | MR. JAY WENDELL REGENCIA SIA |
NPI Number: | 1811319767 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PT25069 |
Business Practice Address: | 875 Wilmette Ave Apt 406 Ormond Beach, FL - 321749515 |
Business Phone Number: | 8634148822 |
Business Fax Number: | |
Mailing Address: | 875 Wimette Ave. Apt 406, ORMOND BEACH |
State: | FL |
Postal Code: | 32174 |
Phone Number: | 8634148822 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2014 |
NPI Last Update Date: | 01/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT25069 |
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 |