Provider Demographics
NPI:1174380596
Name:DE LA CRUZ-GALINDO, ENRIQUE (ATC)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:DE LA CRUZ-GALINDO
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15815 S LAKEWOOD PKWY W APT 2038
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7292
Mailing Address - Country:US
Mailing Address - Phone:425-315-3109
Mailing Address - Fax:
Practice Address - Street 1:2612 W GILA BEND HWY
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85193-9303
Practice Address - Country:US
Practice Address - Phone:520-374-2942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer