Provider Demographics
NPI:1669874715
Name:ZAPANTA, JEANETTE BACOLOD (MSPT)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:BACOLOD
Last Name:ZAPANTA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 THISTLE DR NW
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-7617
Mailing Address - Country:US
Mailing Address - Phone:252-378-1151
Mailing Address - Fax:
Practice Address - Street 1:4200 THISTLE DR NW
Practice Address - Street 2:APARTMENT A
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-7617
Practice Address - Country:US
Practice Address - Phone:252-378-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist