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1134759186
PHOENIX REBELLION THERAPY, LLC
MURRAY, UT
NPI
1134759186
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Entity Type
Organization
Authorized Contact
ROD WALLER
President/Exec Director
385-231-8387
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2020-01-17
Last Update Date
2023-01-18
Business Address
PHOENIX REBELLION THERAPY, LLC
4516 S 700 E STE 360
MURRAY, UT 84107-8317
Phone number: 385-231-8387
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Mailing Address
PHOENIX REBELLION THERAPY, LLC
4516 S 700 E STE 360
MURRAY, UT 84107-8317
Phone number: 385-231-8387
Copy
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