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Individual

LUAR ARJAY DU LEGUA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1208 LUTHER ST, EADS, CO 81036-0817
(719) 438-5401
(719) 438-5391
Mailing address
4716 176TH ST SW, APT C1, LYNNWOOD, WA 98037-3465
(719) 250-7706

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00010660
WA
225100000X
Physical Therapist
Primary
PTL-8449
CO

Other

Enumeration date
09/30/2010
Last updated
03/14/2013
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