Individual
JUSTIN DWIGHT ROYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
12355 W COCOPAH ST, AVONDALE, AZ 85323-3120
(480) 213-4682
Mailing address
12355 W COCOPAH ST, AVONDALE, AZ 85323-3120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13179
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13179
STATE LICENSE
AZ
Enumeration date
08/30/2017
Last updated
08/30/2017
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