Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | IL | |
N | 2251G0304X | Physical Therapist - Geriatrics | 2006032128 | MO |
NPI | 1235358110 |
---|---|
Provider Name | Mrs. Maribel Erpelo Aparentado |
First Address | Joplin, MO 64801-2501 |
Second Address | Danville, IL 61832-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/07/2007 |