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Individual

VINCENT PAULO FORMALEJO PANGANIBAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
6420 S 6TH ST, KLAMATH FALLS, OR 97603-7111
(541) 887-2090
Mailing address
6420 S 6TH ST, KLAMATH FALLS, OR 97603-7111
(541) 887-2090

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60437
OR

Other

Enumeration date
01/08/2014
Last updated
08/26/2024
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