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Individual
RIZARUTH MARCOS BRAVO
Active
Individual
RIZARUTH MARCOS BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01183900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA01183900
PHYSICAL THERAPIST LIC.#
NJ
Enumeration date
04/03/2007
Last updated
07/08/2007
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