Individual
MR. JUAN R TOLENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
690 MEDICAL PARK DR, AIKEN, SC 29801-6348
(803) 648-8344
Mailing address
1316 WENDELL LN, GROVETOWN, GA 30813-5279
(706) 860-7974
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2993
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1283
—
SC
Enumeration date
11/14/2006
Last updated
08/31/2009
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