Provider Demographics
NPI:1912178740
Name:RAMOS, JANICE IAN (RPT)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:IAN
Last Name:RAMOS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W 5TH ST
Mailing Address - Street 2:SUITE D&E
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-2501
Mailing Address - Country:US
Mailing Address - Phone:417-782-2917
Mailing Address - Fax:417-782-7038
Practice Address - Street 1:110 N FRONT ST
Practice Address - Street 2:
Practice Address - City:DANFORTH
Practice Address - State:IL
Practice Address - Zip Code:60930
Practice Address - Country:US
Practice Address - Phone:773-841-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070015519225100000X
MO2006032145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist