| NPI | 1275692089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEG WAGNER RODNEY Physical Therapist 928-210-2413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: AZ 5016) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP0892) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2008-03-21 |