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1538982061
JACOB DALTON PISTOL MILLS
QUEEN CREEK, AZ
NPI
1538982061
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: AZ 014294)
Enumeration Date
2024-11-04
Last Update Date
2024-11-04
Business Address
JACOB DALTON PISTOL MILLS PTA
21576 S ELLSWORTH LOOP RD STE 108
QUEEN CREEK, AZ 85142-1068
Phone number: 602-737-2275
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Mailing Address
JACOB DALTON PISTOL MILLS PTA
552 W LOVE RD
SAN TAN VALLEY, AZ 85143-4808
Phone number: 480-694-2245
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