Individual
ALEXIS VILLANUEVA CHAVENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
3801 OLD BRUCEVILLE RD, VINCENNES, IN 47591-3889
(812) 886-4677
(812) 886-4678
Mailing address
8734 NAVIGATOR DR, SUITE 1307, INDIANAPOLIS, IN 46237-2992
(646) 508-6912
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
026027A
NY
225100000X
Physical Therapist
Primary
05008117A
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026027A
PROFESSIONAL LICENSE
NY
01
—
05008117A
PROFESSIONAL LICENSE
IN
Enumeration date
03/07/2007
Last updated
07/27/2012
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