| NPI | 1215435847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN ROSS SANDBERG Owner 480-729-2925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT39349) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2024-09-04 |