Individual
EUSTAQUIO IBIAS DEVILLA
Active
Individual
EUSTAQUIO IBIAS DEVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
B1362743
—
225100000X
Physical Therapist
0000004337
TN
225100000X
Physical Therapist
18054
MD
225100000X
Physical Therapist
Primary
2305204220
VA
225100000X
Physical Therapist
2572
SC
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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