Provider Demographics
NPI:1558637983
Name:PUENTES DE VELOZ, NORMA ANGELICA
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:ANGELICA
Last Name:PUENTES DE VELOZ
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 1:4320 VENZA ST
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-0621
Mailing Address - Country:US
Mailing Address - Phone:775-727-8791
Mailing Address - Fax:
Practice Address - Street 1:4320 VENZA ST
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-0621
Practice Address - Country:US
Practice Address - Phone:775-727-8791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner