| NPI | 1194167858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN TAIT President 520-777-9385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 5503) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: AZ 5503) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2023-08-15 |