Individual
MARILYNN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
86 W SALT MINE RD, CAMP VERDE, AZ 86322-7013
(928) 567-5253
Mailing address
86 W SALT MINE RD, CAMP VERDE, AZ 86322-7013
(928) 567-5253
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6640A
AZ
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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