Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 11519 | AZ |
NPI | 1144606401 |
---|---|
Provider Name | Omolade Akinremi |
First Address | El Mirage, AZ 85335-6378 |
Second Address | Scottsdale, AZ 85260-6720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2015 |
Last Update Date | 09/08/2015 |