Individual
AUSTIN R WIDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
13967 W GRAND AVE STE 100, SURPRISE, AZ 85374-3732
(623) 474-3952
(623) 474-3953
Mailing address
15410 S MOUNTAIN PKWY STE 112, PHOENIX, AZ 85044-6691
(480) 706-1161
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
32088
AZ
Other
Enumeration date
12/01/2021
Last updated
12/13/2021
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