Individual
HUMBERTO GRIMALDO-SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
105 N 5TH AVE, MADILL, OK 73446-1200
(580) 795-3301
(580) 795-7307
Mailing address
811 W BURNEY ST, MADILL, OK 73446-2642
(580) 263-8484
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1948
OK
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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