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Individual

MR. ROLAN SEGOVIA GOLEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
388 YPAO RD, TAMUNING, GU 96913-3701
(671) 646-8881
(671) 646-1292
Mailing address
388 YPAO RD, TAMUNING, GU 96913-3701
(671) 646-8881
(671) 646-1292

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-105
GU
225100000X
Physical Therapist
PT-3401
HI
225100000X
Physical Therapist
PT-90
GU

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669744983
GU
01
H112215
MEDICARE PTAN
GU
Enumeration date
02/01/2012
Last updated
04/25/2023
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