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Individual

MICHELLE R. PIPKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S. P. T.

Contact information

Practice address
17999 W. SURPRISE FARMS LOOP SOUTH, SURPRISE, AZ 85388
(623) 876-7388
Mailing address
3637 W CHARLESTON AVE, GLENDALE, AZ 85308-2808
(602) 561-5213

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2536
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2536
PT LICENSE NUMBER
AZ
Enumeration date
01/25/2007
Last updated
07/08/2007
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