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1902407976
PAWAT POUPONGTONG
BUCKEYE, AZ
NPI
1902407976
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: AZ 30798)
Enumeration Date
2020-11-05
Last Update Date
2020-11-05
Business Address
PAWAT POUPONGTONG DPT
23350 W YUMA RD
BUCKEYE, AZ 85326-3106
Phone number: 623-242-6908
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Mailing Address
PAWAT POUPONGTONG DPT
17830 N 45TH AVE
GLENDALE, AZ 85308-1650
Phone number: 562-455-3886
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