Individual
MR. PAUL JOHN GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
375 E VIRGINIA AVE, SUITE B, PHOENIX, AZ 85004-1220
(602) 264-5323
(602) 264-5302
Mailing address
375 E VIRGINIA AVE, SUITE B, PHOENIX, AZ 85004-1220
(602) 264-5323
(602) 264-5302
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0656
AZ
2251S0007X
Sports Physical Therapist
0656
AZ
2251X0800X
Orthopedic Physical Therapist
0656
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
781387
—
AZ
Enumeration date
03/08/2006
Last updated
11/27/2007
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