| NPI | 1144718644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CORMIER Owner 480-306-7227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2024-01-10 |