Individual
JUAN BERUMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1388 S 159TH AVE, UNITED STATES, GOODYEAR, AZ 85338-3313
(623) 826-6209
Mailing address
1388 S 159TH AVE, GOODYEAR, AZ 85338-3313
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12196A
AZ
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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