Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MODESTO KING ANDREW ESGUERRA FORMILLEZA V, OTR
ActiveMR. MODESTO KING ANDREW ESGUERRA FORMILLEZA V, OTR is a Physical Rehabilitation Occupational Therapist healthcare provider located in CRESWELL, Oregon. NPI 1285944561 is currently active in the NPPES registry. Verify at CMS.
Physical Rehabilitation Occupational Therapist · CRESWELL, OR
Registration Details
- NPI Number
- 1285944561
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 20, 2010 (15.629977512599 yrs)
- Last Updated
- Oct 20, 2010
- License
-
260743 (OR)
Practice Information
- Address
-
735 S 2ND STCRESWELL, OR, 974267507Browse OR providers · Browse ZIP 97426
- Phone
- 5418953333
- Primary Specialty
-
Physical Rehabilitation Occupational Therapist
225XP0019X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.