Individual
JACQUELINE LIANA PUNO
Active
Individual
JACQUELINE LIANA PUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03429
KS
225100000X
Physical Therapist
2004012265
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37606031
BCBS KC
—
01
—
750842
OPTUM
—
01
—
KA2868008
MEDICARE PTAN
KS
01
—
MA4370065
MEDICARE PTAN
MO
01
—
P01246857
MEDICARE RAILROAD
KS
Enumeration date
11/06/2006
Last updated
05/15/2018
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