Individual
MICAH D FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2990 N CAMPBELL AVE STE 220, TUCSON, AZ 85719-2995
(520) 407-5706
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
(866) 370-8206
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11564
AZ
225100000X
Physical Therapist
Primary
CP039992T
AZ
Other
Enumeration date
02/28/2024
Last updated
02/05/2025
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