Individual
JAQUELINE FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10769 N FRANK LLOYD WRIGHT BLVD STE A110, SCOTTSDALE, AZ 85259-2688
(602) 405-8182
Mailing address
10769 N FRANK LLOYD WRIGHT BLVD STE A110, SCOTTSDALE, AZ 85259-2688
(602) 405-8182
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MT-09340
AZ
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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