Provider Demographics
NPI:1275231284
Name:AVILES, FRANCISCO JR (PT, CWS, CLT-LANA)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:AVILES
Suffix:JR
Gender:M
Credentials:PT, CWS, CLT-LANA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2051
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-2051
Mailing Address - Country:US
Mailing Address - Phone:318-228-5056
Mailing Address - Fax:
Practice Address - Street 1:1505 NORTHSIDE BLVD STE 1300
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7624
Practice Address - Country:US
Practice Address - Phone:770-746-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04763R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist