Provider Demographics
NPI:1437820115
Name:RAMIREZ, RAYMOND (ATC)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 2 BOX 242
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96264-0003
Mailing Address - Country:US
Mailing Address - Phone:817-683-5814
Mailing Address - Fax:
Practice Address - Street 1:KUNSAN AIR BASE
Practice Address - Street 2:SEONYEON-RI, OKSEO-MYEON AVENUE C, BUILDING #755
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96264
Practice Address - Country:US
Practice Address - Phone:817-683-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00-1290-012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer