Individual
JUDITH RIVERA CANLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4011 GATEWAY BLVD, NEWBURGH, IN 47630-8947
(812) 842-3990
(812) 842-3738
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 842-3990
(812) 842-3738
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01062700A
IN
208100000X
Physical Medicine & Rehabilitation Physician
39928
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200833900
—
IN
05
—
64126907
—
KY
Enumeration date
07/19/2006
Last updated
07/21/2022
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