Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 018490-1 | NY |
Y | 2251G0304X | Physical Therapist - Geriatrics | 13298 | NC |
NPI | 1013184688 |
---|---|
Provider Name | Julio A Vega JR. |
First Address | Cary, NC 27519-8727 |
Second Address | Cary, NC 27519-8727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 18/08/2011 |