Individual
JENNIFER BLIVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
99 W CALLE GOTA, SAHUARITA, AZ 85629-7847
(520) 780-8829
Mailing address
99 W CALLE GOTA, SAHUARITA, AZ 85629-7847
(520) 780-8829
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6681A
AZ
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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