Individual
MR. ORVILLE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
31672 N 131ST AVE, PEORIA, AZ 85383-7897
(623) 606-6734
Mailing address
31672 N 131ST AVE, PEORIA, AZ 85383-7897
(623) 606-6734
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
30765
AZ
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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