Individual
JESSICA MUELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
480 S WILLARD ST, COTTONWOOD, AZ 86326-4128
(928) 649-9726
(928) 634-2079
Mailing address
480 S WILLARD ST, COTTONWOOD, AZ 86326-4128
(928) 649-9726
(928) 634-2079
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
004923
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004923
ARIZONA PTA LICENSE
AZ
Enumeration date
07/27/2012
Last updated
07/27/2012
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