Provider Demographics
NPI:1093729980
Name:GARCIA, ALBERTO ALFONSO (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ALBERTO
Middle Name:ALFONSO
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 E CIRCULO LAS CABANAS
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-7709
Mailing Address - Country:US
Mailing Address - Phone:520-571-6749
Mailing Address - Fax:
Practice Address - Street 1:1815 N MASTICK WAY STE 2
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-1058
Practice Address - Country:US
Practice Address - Phone:520-281-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52692251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ78564Medicare ID - Type UnspecifiedMEDICARE NUMBER