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General NPI Number Information
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NPI Number | 1447038609
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Entity Type | Individual
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Provider Name | BENEDICT JOMAL ARROYO ROSA ATC
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Gender | Male
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3805 N 53RD AVE
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City | PHOENIX
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State | AZ
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Zip | 85031-3046
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Country | US
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Telephone | 414-218-3939
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Fax |
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Provider Business Mailing Address
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Address Line | 30971 W COLUMBUS AVE
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City | BUCKEYE
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State | AZ
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Zip | 85396-6821
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Country | US
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Telephone | 602-420-3653
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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 | 3100-39
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License Number State | WI
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