Provider Demographics
NPI:1871611954
Name:RAMIREZ DE ARELLANO, RAFAEL F (RPT)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:F
Last Name:RAMIREZ DE ARELLANO
Suffix:
Gender:M
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:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:SLATYFORK
Mailing Address - State:WV
Mailing Address - Zip Code:26291-0104
Mailing Address - Country:US
Mailing Address - Phone:304-572-4378
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 500
Practice Address - Street 2:
Practice Address - City:MARLINTON
Practice Address - State:WV
Practice Address - Zip Code:24954-9754
Practice Address - Country:US
Practice Address - Phone:304-799-7375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist