Individual
KENNETH REPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
14800 W MOUNTAIN VIEW BLVD, SUITE 260, SURPRISE, AZ 85374-4795
(623) 556-5013
(623) 556-9290
Mailing address
14800 W MOUNTAIN VIEW BLVD, SUITE 260, SURPRISE, AZ 85374-4795
(623) 556-5013
(623) 556-9290
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5491A
AZ
Other
Enumeration date
12/03/2012
Last updated
12/30/2016
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