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Richard Moreno Jr.

Physical Therapy Assistant in Glendale, AZ. Individual provider (NPI-1).

NPI number1649667635
StatusActive
Last updated in NPPESApr 17, 2015

Details

NPI
1649667635
Entity type
Individual (NPI-1)
Name
Richard Moreno Jr.
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 17, 2015
Last updated
Apr 17, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant11463aAZYes

Practice location

6509 W Acapulco Ln
Glendale, AZ 85306

Phone 602-421-8231

Mailing address

6509 W Acapulco Ln
Glendale, AZ 85306

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