Individual
MIRIAM BERENICE RENDON ZAVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6550 E 2ND ST STE B, PRESCOTT VALLEY, AZ 86314-3523
(928) 777-1932
Mailing address
4512 W EDGEMONT AVE, PHOENIX, AZ 85035-2212
(480) 386-2166
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
013789
AZ
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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