Mark Luck Lito Villa Cubillas, RPT

NPI #1083388581 in Sonoma, California

Provider Information

NPI Number: 1083388581
Entity Type: Individual
Name: Mark Luck Lito Villa Cubillas, RPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: RPT
Enumeration Date: Aug 6, 2021
Last Updated: Aug 6, 2021

Practice Location

Address: 1250 BROADWAY
City: Sonoma
State: California
ZIP Code: 95476-7500
Phone: (707) 938-8406

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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