Provider Demographics
NPI:1689847030
Name:SAYO, ANGEL RODRIGO MERCADO JR (PT)
Entity type:Individual
Prefix:
First Name:ANGEL RODRIGO
Middle Name:MERCADO
Last Name:SAYO
Suffix:JR
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 1:1415 PINECREST LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-3946
Mailing Address - Country:US
Mailing Address - Phone:985-643-1397
Mailing Address - Fax:
Practice Address - Street 1:1415 PINECREST LN
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70460-3946
Practice Address - Country:US
Practice Address - Phone:985-643-1397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT 01301F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist