Organization
PROTHERAPY STAFFING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MICHUDA DPT (OWNER)
(260) 241-7887
Entity
Organization
Contact information
Practice address
402 E GREENWAY PKWY, PHOENIX, AZ 85022-2350
(602) 789-6878
Mailing address
219 MILK RIVER DRIVE, FORT PECK, MT 59223
(605) 593-6700
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
11779
AZ
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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