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Individual

MR. REYNALDO CABANILLA CABARLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
403 WEST CENTRAL AVE., JAMESTOWN, TN 38556-1170
(931) 879-4301
(931) 879-4302
Mailing address
PO BOX 1170, JAMESTOWN, TN 38556-1170
(931) 879-4301
(931) 879-4302

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1466
TN
225100000X
Physical Therapist
Primary
PT1466
TN
261QP2000X
Physical Therapy Clinic/Center
1466
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0063840
BCBS
TN
05
4448120
TN
Enumeration date
12/19/2006
Last updated
12/10/2007
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