Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1218512 | TX |
NPI | 1003161423 |
---|---|
Provider Name | Jennifer Loren Alcala |
First Address | El Paso, TX 79930-4916 |
Second Address | El Paso, TX 79907-4159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2012 |
Last Update Date | 23/07/2012 |