| NPI | 1194813279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN OVETA FONSECA Chief Administrative Officer 480-735-0124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: AZ OTC 3407) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |