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Individual

ISRAEL MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
15410 S MOUNTAIN PKWY STE 112, PHOENIX, AZ 85044
(480) 689-5509
Mailing address
2979 E PALMDALE LN, GILBERT, AZ 85298-5708

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7756
AZ

Other

Enumeration date
10/13/2009
Last updated
11/12/2018
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