Individual
MR. JERRY WALTER COY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
44400 W HONEYCUTT RD, STE 101, MARICOPA, AZ 85138-2944
(602) 770-0263
Mailing address
44640 W YUCCA LN, MARICOPA, AZ 85138-4036
(602) 770-0263
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT-05220
AZ
225700000X
Massage Therapist
Primary
MT-05220
AZ
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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