Provider Demographics
NPI:1851103626
Name:ESPINOSA, REGINALD JOY B (PT, DPT)
Entity type:Individual
Prefix:
First Name:REGINALD JOY
Middle Name:B
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 KENNEDY ROAD
Mailing Address - Street 2:APT.1004
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ON
Mailing Address - Zip Code:M1K 2B7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:824 S HURON ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-2210
Practice Address - Country:US
Practice Address - Phone:231-627-4347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist