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General NPI Number Information
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NPI Number | 1669953923
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Entity Type | Individual
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Provider Name | RAMON VILLA III PTA
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Gender | Male
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 03/27/2021
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Provider Practice Location Address
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Address Line | 7800 E PIERCE ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85257-4606
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Country | US
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Telephone | 480-640-1135
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Fax | 480-597-1734
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Provider Business Mailing Address
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Address Line | 1336 W LAWRENCE LN
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City | PHOENIX
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State | AZ
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Zip | 85021-4439
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Country | US
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Telephone |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 12098A
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License Number State | AZ
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