NPI 1356523450

Geno Roman Rivera, PTA

Practitioner Physical Therapy Assistant Fountain Hills, AZ

Practice location

Address: 16605 E Palisades Blvd STE 144, Fountain Hills, AZ 85268-3717
Phone: (602) 571-4407
Mailing address: 4247 E Roma Ave, Phoenix, AZ 85018-4250

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 7926A (AZ)

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Registry record

NPI: 1356523450
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Nov 2007
Record last updated: 29 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.