Provider Demographics
NPI:1831413434
Name:SERVICIOS DE TERAPIA FISICA AIC, CSP
Entity type:Organization
Organization Name:SERVICIOS DE TERAPIA FISICA AIC, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:I
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT
Authorized Official - Phone:787-850-1337
Mailing Address - Street 1:PO BOX 9030
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-9030
Mailing Address - Country:US
Mailing Address - Phone:787-850-1337
Mailing Address - Fax:787-850-1337
Practice Address - Street 1:9 CALLE RAFAEL ARROYO RIOS S
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3932
Practice Address - Country:US
Practice Address - Phone:787-850-1337
Practice Address - Fax:787-850-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR776261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy