Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 06772 | AZ |
NPI | 1003585688 |
---|---|
Provider Name | Maria Dolores Robinson |
First Address | Green Valley, AZ 85614-2325 |
Second Address | Green Valley, AZ 85614-6113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2021 |
Last Update Date | 08/09/2021 |