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General NPI Number Information
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NPI Number | 1356775829
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Entity Type | Individual
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Provider Name | CINDY MARIE STORCH PTA
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Gender | Female
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Dates
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Enumeration Date | 09/02/2013
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Last Update Date | 09/02/2013
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Provider Practice Location Address
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Address Line | 13373 N PLAZA DEL RIO BLVD
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City | PEORIA
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State | AZ
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Zip | 85381-4873
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Country | US
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Telephone | 866-360-8327
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Fax |
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Provider Business Mailing Address
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Address Line | 14463 W WELDON AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-8280
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Country | US
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Telephone | 623-932-9358
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 6964A
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License Number State | AZ
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