Individual
LARA DE VARGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4210 E BASELINE RD STE 106, MESA, AZ 85206-4418
(480) 503-2373
Mailing address
1778 W 10TH AVE, APACHE JUNCTION, AZ 85120-6930
(714) 402-4136
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
014433
AZ
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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