Individual
MR. VICENTE O. ENCISO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8611 N 67TH AVE, GLENDALE, AZ 85302-4351
(623) 939-9475
Mailing address
11721 W JEFFERSON ST, AVONDALE, AZ 85323-1195
(623) 313-4655
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5589A
AZ
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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