| NPI | 1194128710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WICK Owner/President 520-471-3764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: AZ 26973) |
| Enumeration Date | 2014-09-28 |
| Last Update Date | 2014-11-21 |