Individual
PAWAT POUPONGTONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
23350 W YUMA RD, BUCKEYE, AZ 85326-3106
(623) 242-6908
Mailing address
17830 N 45TH AVE, GLENDALE, AZ 85308-1650
(562) 455-3886
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
30798
AZ
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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