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Individual

ROSS BENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
17100 N 67TH AVE, BUILDING 100, GLENDALE, AZ 85308-3605
(623) 979-2747
Mailing address
5401 E VAN BUREN ST UNIT 3017, PHOENIX, AZ 85008-3466
(402) 981-7190

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10118A
PTA
AZ
Enumeration date
06/09/2014
Last updated
06/09/2014
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