Individual
ROBERTA TANTIMONACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
126 E MAIN ST, PAYSON, AZ 85541-5488
(928) 951-0587
Mailing address
126 E MAIN ST, PAYSON, AZ 85541-5488
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006908
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPT-006908
AZ STATE BOARD OF PHYSICAL THERAPY
AZ
Enumeration date
02/14/2018
Last updated
05/01/2023
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