Individual
AMANDA MAE AUSTIN RENFROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W GUADALUPE RD, TEMPE, AZ 85283-3599
(480) 839-0292
Mailing address
3735 E SHANGRI LA RD, PHOENIX, AZ 85028-2816
(602) 795-6246
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5375
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
539091
AHCCCS ID NUMBER
AZ
Enumeration date
02/07/2007
Last updated
07/08/2007
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