Individual
JACQUELYN POVILAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7810 N US HIGHWAY 89 STE 270-280, FLAGSTAFF, AZ 86004-6255
(928) 522-8375
Mailing address
7810 N US HIGHWAY 89 STE 270-280, FLAGSTAFF, AZ 86004-6255
(928) 522-8375
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
012236
AZ
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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