Individual
MR. LUKE ANTON VIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
10730 W CAMPBELL AVE, PHOENIX, AZ 85037-5400
(623) 772-2580
Mailing address
10730 W CAMPBELL AVE, PHOENIX, AZ 85037-5400
(623) 772-2580
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4202
AZ
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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