Individual
MR. BERT GUY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.T.A.
Contact information
Practice address
7540 N 19TH AVE, PHOENIX, AZ 85021-7967
(888) 873-4221
Mailing address
3320 ARROWWOOD DR, LAKE HAVASU CITY, AZ 86406-6274
(928) 854-3538
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4430
AZ
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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