Individual
EMMANUEL PERALTA BAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPY
Contact information
Practice address
720 12TH ST SE, AUBURN, WA 98002-6708
(253) 735-3606
(253) 351-9807
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
042599
NY
225100000X
Physical Therapist
—
WA
Other
Enumeration date
11/30/2018
Last updated
12/12/2023
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