Individual
AMANDA BRUEBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7255 E BROADWAY RD, MESA, AZ 85208-9201
(480) 981-8844
Mailing address
1873 E SAN TAN ST, CHANDLER, AZ 85225-8240
(480) 734-1573
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10294A
AZ
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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