Provider Demographics
NPI:1225369812
Name:ESCOBAR, ERWIN TOLENTINO (PT)
Entity Type:Individual
Prefix:MR
First Name:ERWIN
Middle Name:TOLENTINO
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7479 BRACKEN PKWY
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6879
Mailing Address - Country:US
Mailing Address - Phone:219-940-3049
Mailing Address - Fax:
Practice Address - Street 1:7479 BRACKEN PKWY
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6879
Practice Address - Country:US
Practice Address - Phone:219-940-3049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009548A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist