Individual
MIGUEL R HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3050 N LITCHFIELD RD, SUITE 100, GOODYEAR, AZ 85395-7804
(623) 935-5505
(653) 935-5551
Mailing address
PO BOX 32490, PHOENIX, AZ 85064-2490
(602) 230-4478
(602) 230-9962
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5127
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252713
—
AZ
Enumeration date
03/19/2007
Last updated
10/19/2007
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