Provider Demographics
NPI:1154616076
Name:VALBUENA, JONATHAN TAN (PT)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:TAN
Last Name:VALBUENA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:DEPARTMENT OF PT-OT
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-1186
Mailing Address - Fax:919-966-0348
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:PHYSICAL THERAPY DEPT
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-2056
Practice Address - Fax:919-966-0348
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP10394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist