Provider Demographics
NPI:1326436155
Name:MANIQUIZ, LENDEL (PT, CWS)
Entity Type:Individual
Prefix:MS
First Name:LENDEL
Middle Name:
Last Name:MANIQUIZ
Suffix:
Gender:F
Credentials:PT, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10283 N RECREATION AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-4741
Mailing Address - Country:US
Mailing Address - Phone:559-244-1438
Mailing Address - Fax:
Practice Address - Street 1:650 W ALLUVIAL AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6716
Practice Address - Country:US
Practice Address - Phone:559-323-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-01
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27187225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist