Individual
LAYRA AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT, MSHCM
Contact information
Practice address
125 S AVONDALE BLVD, AVONDALE, AZ 85323-5212
(480) 442-8059
(623) 907-8600
Mailing address
125 S AVONDALE BLVD, AVONDALE, AZ 85323-5212
(480) 442-8059
(623) 907-8600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10853
AZ
2251G0304X
Geriatric Physical Therapist
10853
AZ
2251N0400X
Neurology Physical Therapist
10853
AZ
2251P0200X
Pediatric Physical Therapist
10853
AZ
2251S0007X
Sports Physical Therapist
10853
AZ
2251X0800X
Orthopedic Physical Therapist
10853
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
908446
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
AZ
Enumeration date
06/18/2014
Last updated
06/18/2014
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