Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1217 | NV |
NPI | 1003134057 |
---|---|
Provider Name | Ceferino Villafuerte |
First Address | Las Vegas, NV 89134-6699 |
Second Address | Las Vegas, NV 89134-6699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2010 |
Last Update Date | 25/08/2014 |