Individual
MARTINA LORAY MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
20045 N 19TH AVE BLDG 8, PHOENIX, AZ 85027-4267
(623) 594-9034
Mailing address
20045 N 19TH AVE BLDG 8, PHOENIX, AZ 85027-4267
(623) 594-9034
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
31948
AZ
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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