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1871611855
MICHAEL M PETKOVIC
TEMPE, AZ
NPI
1871611855
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: AZ 1822)
Enumeration Date
2007-03-27
Last Update Date
2009-09-15
Business Address
-- MICHAEL M PETKOVIC OT
1930 E SOUTHERN AVE
TEMPE, AZ 85282-7518
Phone number: 480-456-0719
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Mailing Address
-- MICHAEL M PETKOVIC OT
1930 E SOUTHERN AVE
TEMPE, AZ 85282-7518
Phone number: 480-456-0719
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