Provider Demographics
NPI:1437484912
Name:CENTENERA, RAQUEL TAMARA TORRES
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:TAMARA TORRES
Last Name:CENTENERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2281 W 24TH ST
Mailing Address - Street 2:#10
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6154
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2281 W 24TH ST
Practice Address - Street 2:#10
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6154
Practice Address - Country:US
Practice Address - Phone:928-344-1656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist