Individual
MR. TOMMY EDWARD MOLINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
18219 W PORT AU PRINCE LN, SURPRISE, AZ 85388-7568
(623) 214-2988
Mailing address
18219 W PORT AU PRINCE LN, SURPRISE, AZ 85388-7568
(623) 214-2988
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1506
AZ
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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