Provider Demographics
NPI:1083928824
Name:JAVIER, JEAN-VICTOR (RPT)
Entity Type:Individual
Prefix:MR
First Name:JEAN-VICTOR
Middle Name:
Last Name:JAVIER
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 S 5TH ST
Mailing Address - Street 2:APT.1
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3990
Mailing Address - Country:US
Mailing Address - Phone:785-787-5290
Mailing Address - Fax:
Practice Address - Street 1:623 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4104
Practice Address - Country:US
Practice Address - Phone:785-826-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04060225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist