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Search › Arizona › Physical Therapy Assistant

Jesse Kusmulyana, PTA

NPI 1467010082 · on the registry since 2019

Practice

Address
103 Medicine Way Rd
Peridot, AZ 85542
Phone
(928) 475-1360
Organisation at this address
Akdhc, Llc
Dhhs Ihs Phoenix Area
San Carlos Apache Healthcare Corporation
San Carlos Apache Healthcare Corporation
San Carlos Apache Healthcare Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address
52

Registry record

Primary taxonomy
Physical Therapy Assistant
225200000X
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-05-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona