Provider Demographics
NPI:1417919366
Name:ASCANO, RAMIL AGANA (PT,MBA,MSM)
Entity Type:Individual
Prefix:MR
First Name:RAMIL
Middle Name:AGANA
Last Name:ASCANO
Suffix:
Gender:M
Credentials:PT,MBA,MSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SUNSET LOOP
Mailing Address - Street 2:
Mailing Address - City:MINOT AFB
Mailing Address - State:ND
Mailing Address - Zip Code:58704-1905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:103 SUNSET LOOP
Practice Address - Street 2:APT 2
Practice Address - City:MINOT AFB
Practice Address - State:ND
Practice Address - Zip Code:58704-1905
Practice Address - Country:US
Practice Address - Phone:701-723-5544
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1020171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider