Individual
CORNELIUS JIM SCANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2650 E SHOW LOW LAKE RD, STE 3, SHOW LOW, AZ 85901-7955
(928) 537-8196
Mailing address
PO BOX 194, PINETOP, AZ 85935-0194
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/02/2006
Last updated
07/08/2007
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