Provider Demographics
NPI:1235537192
Name:PIOQUINTO, PRECILA (PT)
Entity Type:Individual
Prefix:
First Name:PRECILA
Middle Name:
Last Name:PIOQUINTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PRECILA
Other - Middle Name:CAMORONGAN
Other - Last Name:DE GUZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3051 WATSON BLVD STE 525
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-8556
Mailing Address - Country:US
Mailing Address - Phone:478-953-4563
Mailing Address - Fax:
Practice Address - Street 1:3051 WATSON BLVD STE 525
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-8556
Practice Address - Country:US
Practice Address - Phone:478-953-4563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist