Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P5699 | NC |
NPI | 1003069501 |
---|---|
Provider Name | Luis B Villar |
First Address | Cary, NC 27519-6464 |
Second Address | Cary, NC 27519-6464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 11/01/2016 |