Provider Demographics
NPI:1548536113
Name:VILLARREAL, VAUGHN THOMAS I (PTA)
Entity type:Individual
Prefix:MR
First Name:VAUGHN
Middle Name:THOMAS
Last Name:VILLARREAL
Suffix:I
Gender:M
Credentials:PTA
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Mailing Address - Street 1:7100 W 13TH AVE
Mailing Address - Street 2:APT 213
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4700
Mailing Address - Country:US
Mailing Address - Phone:303-770-4682
Mailing Address - Fax:303-770-4812
Practice Address - Street 1:7100 W 13TH AVE
Practice Address - Street 2:APT 213
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4700
Practice Address - Country:US
Practice Address - Phone:303-770-4682
Practice Address - Fax:303-770-4812
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant