Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 05010983A | IN |
N | 2251C2600X | Cardiopulmonary | 05010983A | IN |
N | 2251S0007X | Physical Therapist - Sports | 05010983A | IN |
N | 2251X0800X | Physical Therapist - Orthopedic | 05010983A | IN |
NPI | 1184067670 |
---|---|
Provider Name | Prof. Alvaro N Gurovich |
First Address | Terre Haute, IN 47802-4975 |
Second Address | Terre Haute, IN 47809-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2013 |
Last Update Date | 16/07/2013 |