Individual
WILIBALDO SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2451 E BASELINE RD STE 100, GILBERT, AZ 85234-2467
(480) 304-5152
Mailing address
5262 E VISTA GRANDE, SAN TAN VALLEY, AZ 85140-6500
(602) 582-9383
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
013777
AZ
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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