NPI | 1104187889 |
---|---|
Entity Type | Organization |
Authorized Contact | WENDY ANN WEISFLOG Owner 480-663-7829 |
Organization Subpart ? | No |
Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: AZ 7193) |
Enumeration Date | 2012-05-30 |
Last Update Date | 2014-04-10 |