Individual
RENEE MICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
5405 W. KERRY LANE, GLENDALE, AZ 85308-4952
(623) 362-3380
Mailing address
5405 W. KERRY LANE, GLENDALE, AZ 85308-4952
(623) 362-3380
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2075
AZ
Other
Enumeration date
05/03/2007
Last updated
09/28/2010
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