Mr. Modesto King Andrew Esguerra Formilleza V
Occupational Therapist - Physical Rehabilitation
735 S 2nd St
Creswell
, Oregon 97426-7507
Mr. Modesto King Andrew Esguerra Formilleza V
Occupational Therapist - Physical Rehabilitation
735 S 2nd St
Creswell
, Oregon 97426-7507
(541) 912-5595
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About
Features
Specialties
- Occupational Therapist - Physical Rehabilitation
Languages spoken
- English
Location
First Address
- Mr. Modesto King Andrew Esguerra Formilleza V
- 4001 Potter St Apt 47
- Eugene, OR
- Zip : 97405-4583
- Phone : (541) 912-5595
Second Address
- Mr. Modesto King Andrew Esguerra Formilleza V
- 735 S 2nd St
- Creswell, OR
- Zip : 97426-7507
- Phone : (541) 895-3333
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 260743 | OR |
National Provider Identifier
| NPI | 1285944561 |
|---|---|
| Provider Name | Mr. Modesto King Andrew Esguerra Formilleza V |
| First Address | Eugene, OR 97405-4583 |
| Second Address | Creswell, OR 97426-7507 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/10/2010 |
| Last Update Date | 20/10/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.