Individual
ANTONIO JOSE LUIS GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 S LA CANADA DR STE 23, GREEN VALLEY, AZ 85614-2662
(254) 338-1028
Mailing address
210 CALLE ARIKARA, RIO RICO, AZ 85648-2900
(520) 338-5556
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT27987
AZ
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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