| NPI | 1366170656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNELLE SUAREZ Owner, Pa, Rendering Provider 480-688-3321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2022-08-12 |