Most Relevant Information
Provider Data
| NPI Number: | 1003425943 |
| Provider Name: | JESSICA MEDRANO PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 013831 |
Most Important Dates
| Enumeration Date: | 07/27/2020 |
| Last Updated: | 07/27/2020 |
Provider Practice Location
14154 S DENNY BLVD
LITCHFIELD PARK
AZ
853409431
Practice Location Phone/Fax
| Phone: | 6235377500 |
| Fax: |
Provider Mailing Location
18041 W YOUNG ST
SURPRISE
AZ
853881617
Provider Mailing Phone/Fax
| Phone: | 6238062257 |
| Fax: |