NPI Profile for AVAYA THERAPY OF ARIZONA LLC in GLENDALE, AZ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Wound Care |
163WW0000X | |||
Community Health |
363LC1500X | 50 | Nurse Practitioner | |
Physical Therapist |
225100000X | 65 | Physical Therapist in Private Practice | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI Number | 1902669807 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/02/2024 | |
| Last updated | 02/02/2024 - About 2 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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