Provider Demographics
NPI:1063288637
Name:LAYUGAN, ZAYPEE KOHLENE PASCUAL
Entity type:Individual
Prefix:
First Name:ZAYPEE KOHLENE
Middle Name:PASCUAL
Last Name:LAYUGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 S FORD DR
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-5410
Mailing Address - Country:US
Mailing Address - Phone:505-236-3711
Mailing Address - Fax:
Practice Address - Street 1:345 BASILIO DR
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-8730
Practice Address - Country:US
Practice Address - Phone:505-721-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPTA1777225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty