Individual
MARIO VINCENT DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
20045 N 19TH AVE BLDG 8, PHOENIX, AZ 85027-4267
(623) 594-9034
Mailing address
20045 N 19TH AVE BLDG 8, PHOENIX, AZ 85027-4267
(623) 594-9034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
30719
AZ
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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