Search › Arizona › 343900000X
Rout Thac
NPI 1477259356 · on the registry since 2023 · sole proprietor
Practice
- Address
- 4911 W Maldonado Rd
Laveen, AZ 85339 - Phone
- (480) 275-1056
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Also registered as
- 251S00000X
251S00000X - Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-02-02
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