Individual
MR. IRWIN ALIVO TANEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
902 BANDERA RD, SAN ANTONIO, TX 78228-4923
(210) 431-4513
(210) 431-4531
Mailing address
800 BASSE RD. APT#511, SAN ANTONIO, TX 78212
(210) 663-2029
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2058013
TX
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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