Provider Demographics
NPI:1386042018
Name:COLON, JOHN (MSPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:COLON
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AC37 CALLE 26
Mailing Address - Street 2:VILLAS DE LOIZA
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-4237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 CARR 165
Practice Address - Street 2:SUITE 303
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8047
Practice Address - Country:US
Practice Address - Phone:787-277-0847
Practice Address - Fax:787-277-0942
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist