| NPI | 1225033483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL DIEHL Owner 928-758-0029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 1526) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 4214) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2007-10-31 |