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Individual

MR. KURT B CHALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
3302 W THOMAS RD, PHOENIX, AZ 85017-5605
(602) 233-0409
Mailing address
29723 N 121ST AVE, PEORIA, AZ 85383-3495
(480) 710-3102

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6583A
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6583A
LICENSE
AZ
Enumeration date
06/26/2007
Last updated
07/08/2007
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