Provider Demographics
NPI:1740615988
Name:LOUNSBERRY GOVEO, WENDY (DPT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:LOUNSBERRY GOVEO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SCOFIELD
Other - Last Name:LOUNSBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:425 CARR. 693 PMB 103
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-439-4892
Mailing Address - Fax:787-626-7842
Practice Address - Street 1:BO. COTTO NORTE SECTOR CAMPO ALEGRE CARR #2 KM 46.4
Practice Address - Street 2:EDIF. LAS VEGAS NUM. 420
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1222225100000X
FLPT21982225100000X
NY015525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist