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1609534205
AUSTIN R WIDICK
SURPRISE, AZ
NPI
1609534205
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: AZ 32088)
Enumeration Date
2021-12-01
Last Update Date
2021-12-13
Business Address
AUSTIN R WIDICK DPT
13967 W GRAND AVE STE 100
SURPRISE, AZ 85374-3732
Phone number: 623-474-3952
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Mailing Address
AUSTIN R WIDICK DPT
15410 S MOUNTAIN PKWY STE 112
PHOENIX, AZ 85044-6691
Phone number: 480-706-1161
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