Provider Demographics
NPI:1386033678
Name:ARMIJO, MICHELLE (RPT)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:ARMIJO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 PEACOCK LN
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5645
Mailing Address - Country:US
Mailing Address - Phone:951-737-1819
Mailing Address - Fax:
Practice Address - Street 1:2477 PEACOCK LN
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5645
Practice Address - Country:US
Practice Address - Phone:951-737-1819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12302225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist