| NPI | 1083928766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW THOMAS Member 480-895-0965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 8030) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 5684) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2019-08-23 |