| NPI | 1396452611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN IAN WELLER Owner 480-874-6808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 208100000X Physical Medicine & Rehabilitation | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 111N00000X Chiropractor | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-08-29 |