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General NPI Number Information
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NPI Number | 1578180659
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Entity Type | Individual
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Provider Name | MAURIVEL RAGLIN PTA
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Gender | Female
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 40 SPUR CIR
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5461
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Country | US
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Telephone | 602-531-6306
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 S PRICE RD APT 271
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City | TEMPE
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State | AZ
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Zip | 85281-6154
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Country | US
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Telephone | 480-600-7063
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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 | 013781
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License Number State | AZ
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