| NPI | 1194059790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C PORTER Member 623-764-2894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2010-01-08 |