Individual
MR. RYAN GUEVARA VILLORENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
21 SUMMIT ST, WEST ORANGE, NJ 07052-1501
(973) 736-2000
Mailing address
21 MERKEL DR, BLOOMFIELD, NJ 07003-3126
(973) 262-4399
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00235000
NJ
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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