Individual
LARRY AYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3131 WESTERN AVE, KINGMAN, AZ 86401-0951
(928) 718-0718
Mailing address
4080 N QUAIL DR, GOLDEN VALLEY, AZ 86413-8043
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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