Provider Demographics
NPI:1972713402
Name:DUENAS, JULIENNE R (PT)
Entity Type:Individual
Prefix:
First Name:JULIENNE
Middle Name:R
Last Name:DUENAS
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 1:241 FARENHOLT AVE
Mailing Address - Street 2:OKA BLDG. STE# 201
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3222
Mailing Address - Country:US
Mailing Address - Phone:671-647-0110
Mailing Address - Fax:671-647-0112
Practice Address - Street 1:241 FARENHOLT AVE
Practice Address - Street 2:OKA BLDG. STE# 201
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3222
Practice Address - Country:US
Practice Address - Phone:671-647-0110
Practice Address - Fax:671-647-0112
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUGUAMPT016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist