Individual
MS. CAROLINE G. HUMBERSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6632 E BASELINE RD, 102, MESA, AZ 85206
(480) 222-0655
(480) 222-1457
Mailing address
15455 N GREENWAY HAYDEN LP, C16, SCOTTSDALE, AZ 85260
(480) 222-0655
(480) 222-1457
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6728
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
929820
—
AZ
Enumeration date
12/26/2006
Last updated
07/21/2008
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