Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Mar 22, 2018
License(s)
1279039 (TX), LPT-30623 (AZ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2305 W ALABAMA ST APT 5105 | Houston, TX 77098-2278 | |
| LOCATION | 9127 W THUNDERBIRD RD STE 101 | Peoria, AZ 85381-4887 | 623-322-0654 |
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