Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 2008298 | TX |
NPI | 1164710943 |
---|---|
Provider Name | Mr. Joseph Gerard Rauma |
First Address | Nacogdoches, TX 75965-1911 |
Second Address | Nacogdoches, TX 75965-1911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2011 |
Last Update Date | 14/07/2011 |