# CENTRO DE TERAPIA FISICA Y ATLETICA NUEVA VIDA PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194048967
- **Authorized official:** IVELISSE MILLET SANTIAGO MSPT (OWNER)
- **Authorized official phone:** (787) 544-6888

## Contact information

- **Practice address:** 462 ATLANTIC VIEW BUILDIN SUITE 2, CARRETERA 2 KM 83.5 MARGINAL CARRIZALES, HATILLO, PR 00659-0000
- **Practice address phone:** (787) 544-6888
- **Practice address fax:** (787) 544-6888
- **Mailing address:** PO BOX 141024, ARECIBO, PR 00614-1024
- **Mailing address phone:** (787) 544-6888
- **Mailing address fax:** (787) 544-6888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 03/09/2010
- **Last updated:** 05/15/2015