Individual
DANA RENE' BANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18441 N 87TH AVE, PEORIA, AZ 85382-8532
(315) 335-9130
Mailing address
PO BOX 132, BLACK CANYON CITY, AZ 85324-0132
(602) 717-3641
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
010335
AZ
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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