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Individual

CASEY TOMPA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11411 N 19TH AVE, PHOENIX, AZ 85029-3642
(602) 256-7500
Mailing address
26249 N 46TH PL, PHOENIX, AZ 85050-8503

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6026147415
AZ
Enumeration date
09/10/2021
Last updated
09/10/2021
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