Individual
BRIAN A RAQUENO
Active
Individual
BRIAN A RAQUENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
39061
CA
225100000X
Physical Therapist
J1-0002540
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548562523
DELAWARE PHYSCIANS CARE
DE
05
—
1548562523
—
DE
Enumeration date
11/24/2010
Last updated
11/30/2021
Update your record
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