Provider Demographics
NPI:1043647712
Name:DEL CASTILLO, VIRGILIO ENRICO PELAEZ (PT)
Entity type:Individual
Prefix:
First Name:VIRGILIO ENRICO
Middle Name:PELAEZ
Last Name:DEL CASTILLO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 W FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84104-2007
Mailing Address - Country:US
Mailing Address - Phone:801-671-5384
Mailing Address - Fax:801-456-8413
Practice Address - Street 1:1003 W FREMONT AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-2007
Practice Address - Country:US
Practice Address - Phone:801-671-5384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist