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General NPI Number Information
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NPI Number | 1912056557
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Entity Type | Individual
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Provider Name | DAVID E CASTILLO PT, MPT, AT/L
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 155 S MONTEZUMA CASTLE HWY STE 2
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City | CAMP VERDE
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State | AZ
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Zip | 86322-7393
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Country | US
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Telephone | 928-300-1936
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Fax | 928-567-8826
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Provider Business Mailing Address
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Address Line | PO BOX 518
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City | CAMP VERDE
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State | AZ
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Zip | 86322-0518
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Country | US
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Telephone | 928-300-1936
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Fax | 928-567-8826
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-007402
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License Number State | AZ
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