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General NPI Number Information
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NPI Number | 1174380596
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Entity Type | Individual
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Provider Name | ENRIQUE DE LA CRUZ-GALINDO ATC
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Gender | Male
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 2612 W GILA BEND HWY
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City | CASA GRANDE
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State | AZ
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Zip | 85193-9303
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Country | US
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Telephone | 520-374-2942
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Fax |
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Provider Business Mailing Address
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Address Line | 15815 S LAKEWOOD PKWY W APT 2038
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City | PHOENIX
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State | AZ
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Zip | 85048-7292
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Country | US
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Telephone | 425-315-3109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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