MEDICARE: THOMAS OCHOA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA-012810	AZ

General Provider Information

NPI Number	:	1821560244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS OCHOA

Provider Business Mailing Address
First Line	:	2252 N 44TH ST APT 1101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-7206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2252 N 44TH ST APT 1101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-7206
Country	:	US
Telephone Number	:	928-304-4298
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/24/2018
Last Update Date	:	12/24/2018

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Directions to “ THOMAS OCHOA ” Practice Location

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