Provider Demographics
NPI:1700227154
Name:HIDALGO-CATUNCAN, BERNADETTE VIDALLO (PT , CLT)
Entity Type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:VIDALLO
Last Name:HIDALGO-CATUNCAN
Suffix:
Gender:F
Credentials:PT , CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 BISHOPS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6290
Mailing Address - Country:US
Mailing Address - Phone:865-769-3894
Mailing Address - Fax:
Practice Address - Street 1:2036 BISHOPS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6290
Practice Address - Country:US
Practice Address - Phone:865-769-3894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT3951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist