Individual
JACK JOEL LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9000 W THUNDERBIRD RD # 205, PEORIA, AZ 85381-4451
(602) 491-1948
(720) 925-5897
Mailing address
5445 DTC PKWY STE 1130, GREENWOOD VILLAGE, CO 80111-3038
(720) 749-5599
(720) 925-5897
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
30858
AZ
225100000X
Physical Therapist
Primary
LPT-30858
AZ
Other
Enumeration date
08/23/2019
Last updated
10/31/2024
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