| NPI | 1194814137 |
|---|---|
| Other Name | LLC |
| Doing Business As | DBA: SPOONER SPORTS INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY SPOONER President 480-551-4958 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 2667) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-03-20 |