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Individual

TANYA ABELLA AZCONA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
15023 21 MILE RD, SHELBY TOWNSHIP, MI 48315-5024
(586) 286-9644
(586) 286-9647
Mailing address
15023 21 MILE RD, SHELBY TOWNSHIP, MI 48315-5024
(586) 286-9644
(586) 286-9647

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502008487
MI

Other

Enumeration date
02/09/2024
Last updated
02/09/2024
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