Individual
MYCHAL LEAUPEPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16640 N 38TH ST, PHOENIX, AZ 85032-2103
(602) 482-6671
Mailing address
3010 W YORKSHIRE DR APT 2150, PHOENIX, AZ 85027-3915
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
013253
AZ
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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