Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 1046 | AZ |
N | 225100000X | Physical Therapist | 1614 | AZ |
NPI | 1063652501 |
---|---|
Provider Name | Dr. Hector Antonio Varela |
First Address | Peoria, AZ 85381-6080 |
Second Address | Peoria, AZ 85381-6080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2009 |
Last Update Date | 07/05/2012 |