Provider Demographics
NPI:1598190068
Name:GARGANTA, RHICA MAY PONTIOSO
Entity Type:Individual
Prefix:MRS
First Name:RHICA MAY
Middle Name:PONTIOSO
Last Name:GARGANTA
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 1:110 SERIO BLVD
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-2013
Mailing Address - Country:US
Mailing Address - Phone:318-757-8671
Mailing Address - Fax:
Practice Address - Street 1:110 SERIO BLVD
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-2013
Practice Address - Country:US
Practice Address - Phone:318-757-8671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07744F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist