Provider Demographics
NPI:1942400098
Name:PENALVA, LUIZ (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MR
First Name:LUIZ
Middle Name:
Last Name:PENALVA
Suffix:
Gender:M
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 VILLAGE HWY
Mailing Address - Street 2:UNIT J
Mailing Address - City:RUSTBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24588-3800
Mailing Address - Country:US
Mailing Address - Phone:434-332-4240
Mailing Address - Fax:
Practice Address - Street 1:1051 VILLAGE HWY
Practice Address - Street 2:UNIT J
Practice Address - City:RUSTBURG
Practice Address - State:VA
Practice Address - Zip Code:24588-3800
Practice Address - Country:US
Practice Address - Phone:434-332-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist