Individual
SPENCER THORSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 S EL MARINO CIR, MESA, AZ 85202-5416
(480) 148-0501
Mailing address
1901 S EL MARINO CIR, MESA, AZ 85202-5416
(480) 748-0501
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5850
AZ
Other
Enumeration date
01/02/2015
Last updated
01/05/2015
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