Provider Demographics
NPI:1225405871
Name:IYEGHA, JOSHUA TORUHJOUWEI (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:TORUHJOUWEI
Last Name:IYEGHA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 MCQUEEN SMITH RD N
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7511
Mailing Address - Country:US
Mailing Address - Phone:334-358-2201
Mailing Address - Fax:
Practice Address - Street 1:640 MCQUEEN SMITH RD N
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7511
Practice Address - Country:US
Practice Address - Phone:334-358-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist