Provider Demographics
NPI:1386749950
Name:VELEZ, FE SOCORRO DAPROZA (PT)
Entity type:Individual
Prefix:
First Name:FE SOCORRO
Middle Name:DAPROZA
Last Name:VELEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:FE SOCORRO
Other - Middle Name:LAGAHIT
Other - Last Name:DAPROZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1398 VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2661
Mailing Address - Country:US
Mailing Address - Phone:770-485-2109
Mailing Address - Fax:
Practice Address - Street 1:2000 MIRROR LAKE BLVD
Practice Address - Street 2:SUITE S
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-2124
Practice Address - Country:US
Practice Address - Phone:770-456-7877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA87992251X0800X
GAPT008799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic