Provider Demographics
NPI:1003069501
Name:VILLAR, LUIS B (PT)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:B
Last Name:VILLAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 DOWN EAST PL
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6464
Mailing Address - Country:US
Mailing Address - Phone:919-656-2140
Mailing Address - Fax:919-336-3009
Practice Address - Street 1:317 DOWN EAST PL
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-6464
Practice Address - Country:US
Practice Address - Phone:919-656-2140
Practice Address - Fax:919-656-2140
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP5699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist