Individual
CLIFF R FORTUNAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
20325 N 51ST AVE STE 8, GLENDALE, AZ 85308-5665
(623) 466-6350
Mailing address
1350 W VAN BUREN ST APT 2018, PHOENIX, AZ 85007-2584
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9477APTA
AZ
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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