Individual
MICHELLE LYNN MASSINGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1320 N 10TH ST STE B, PHOENIX, AZ 85006-2710
(602) 839-7285
(602) 839-7272
Mailing address
1320 N 10TH ST STE B, PHOENIX, AZ 85006-2710
(602) 839-7285
(602) 839-7272
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3764
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807837
—
AZ
Enumeration date
01/31/2013
Last updated
10/29/2013
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