NPI 1417685397

Bronsun Bouyasith Phengdy, PTA

Practitioner Physical Therapy Assistant Avondale, AZ

Practice location

Address: 10450 W McDowell Rd, Avondale, AZ 85392-4901
Phone: (623) 846-7614
Mailing address: 2215 W Highland Ave, Phoenix, AZ 85015-4028

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X

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Registry record

NPI: 1417685397
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2022
Record last updated: 9 Aug 2022

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.