Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 7561 | AZ |
NPI | 1023505096 |
---|---|
Provider Name | Dr. Mark Gerard Almanza |
First Address | Phoenix, AZ 85022-2937 |
Second Address | Phoenix, AZ 85014-6008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2018 |
Last Update Date | 14/04/2021 |