Provider Demographics
NPI:1790062818
Name:VAZQUEZ, MILAGROS G (PT)
Entity Type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:G
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 FRANKLIN LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-1405
Mailing Address - Country:US
Mailing Address - Phone:615-867-8349
Mailing Address - Fax:
Practice Address - Street 1:412 ANNADEL ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-3772
Practice Address - Country:US
Practice Address - Phone:931-249-5779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43872251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics