Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 6216 | AZ |
N | 2251N0400X | Physical Therapist - Neurology |
NPI | 1083826770 |
---|---|
Provider Name | Dr. Barbara Maxwell |
First Address | Queen Creek, AZ 85242-6938 |
Second Address | Mesa, AZ 85206-3618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 08/07/2007 |