Individual
JESSICA SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1828 E FLORENCE BLVD STE 102, CASA GRANDE, AZ 85122-4783
(502) 510-0360
Mailing address
23374 W YUMA RD STE 104, BUCKEYE, AZ 85326-3120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-32121
AZ
Other
Enumeration date
08/08/2022
Last updated
08/11/2025
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