| NPI | 1073610440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACY LA' NETTE WYSOPAL CEO 623-556-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-10-21 |