Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 9980 | AZ |
NPI | 1003282815 |
---|---|
Provider Name | Robin Golden |
First Address | Chandler, AZ 85225-8159 |
Second Address | Chandler, AZ 85225-8159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2015 |
Last Update Date | 15/08/2015 |