SOL JOHANNA JAQUE

LAKE HAVASU CITY, AZ
NPI1750153615
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: AZ  PTA-014722)
Enumeration Date2023-10-24
Last Update Date2023-10-24
Business Address
SOL JOHANNA JAQUE PTA
191 SWANSON AVE STE 102
LAKE HAVASU CITY, AZ 86403-6699
Phone number: 928-855-7880
Mailing Address
SOL JOHANNA JAQUE PTA
191 SWANSON AVE STE 102
LAKE HAVASU CITY, AZ 86403-6699
Phone number:
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