Individual provider · Type 1 NPI
Agnes Lucas Vigilia-Maraya, PHYSICAL THERAPIST
Pediatric Physical Therapist · Fort Wayne, IN
Practice location
8110 Northbury Dr
Fort Wayne, IN 46818-1843
Fax (260) 489-3704
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Physical Therapist Primary | 2251P0200X | PT05002613A (IN) |
Pediatric Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical th…
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About NPI 1376760264
Agnes Lucas Vigilia-Maraya, PHYSICAL THERAPIST's National Provider Identifier is 1376760264, issued on Apr 20, 2007. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 9, 2007.