MR. Luis Fernando Rivera JR., PTA

NPI #1740557313 in Spanaway, Washington

Provider Information

NPI Number: 1740557313
Entity Type: Individual
Name: MR. Luis Fernando Rivera JR., PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Credential: PTA
Enumeration Date: Nov 25, 2011
Last Updated: Nov 25, 2011

Practice Location

Address: 21415 43RD AVENUE CT E
City: Spanaway
State: Washington
ZIP Code: 98387-6841
Phone: (253) 359-4195

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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