Individual
DR. RONALD DAVID PEACOCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
580 N CAMINO MERCADO # 26, CASA GRANDE, AZ 85122-5757
(855) 331-7522
Mailing address
580 N CAMINO MERCADO STE 26, CASA GRANDE, AZ 85122-5757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-30215
AZ
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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