Individual
MARSHALL DOUGLAS BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1534 E RAY RD STE 104, GILBERT, AZ 85296-4429
(480) 855-5542
(480) 855-5756
Mailing address
1534 E RAY RD STE 104, GILBERT, AZ 85296-4429
(480) 855-5542
(480) 855-5756
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
13957
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13957
PTA STATE LLICENCE
AZ
Enumeration date
09/11/2019
Last updated
09/11/2019
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