Provider Demographics
NPI:1619093994
Name:RAMONESWELLS, LILIMORE VILLAFLOR (PT)
Entity Type:Individual
Prefix:
First Name:LILIMORE
Middle Name:VILLAFLOR
Last Name:RAMONESWELLS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W BURLINGTON AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-3243
Mailing Address - Country:US
Mailing Address - Phone:641-469-3130
Mailing Address - Fax:641-469-3131
Practice Address - Street 1:400 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-3713
Practice Address - Country:US
Practice Address - Phone:641-469-4353
Practice Address - Fax:641-469-4288
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist