| NPI | 1043657893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS INCLEDON Managing Member 480-294-0542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 47294) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-11 |