Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | LPT-31051 | AZ |
NPI | 1013555168 |
---|---|
Provider Name | Ashley Rubenstein |
First Address | Peoria, AZ 85383-3565 |
Second Address | Peoria, AZ 85381-4253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 26/11/2021 |