Individual
MS. MARY ELLEN JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2423 W DUNLAP AVE, SUITE 170, PHOENIX, AZ 85021-2830
(602) 870-1414
(602) 870-4141
Mailing address
3824 E CAMPBELL AVE, PHOENIX, AZ 85018-3568
(480) 290-2974
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7174A
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7174A
LICENSE
AZ
Enumeration date
11/03/2006
Last updated
07/08/2007
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