Individual
JESSICA TITUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6553 E BAYWOOD AVE, STE 205, MESA, AZ 85206-1752
(480) 396-9922
Mailing address
777 W CHANDLER BLVD, CHANDLER, AZ 85225-2506
(508) 561-5281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7274
LICENSE #
AZ
Enumeration date
08/30/2006
Last updated
07/08/2007
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