| NPI | 1417738824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSETTE SULLINS CEO/Owner 480-225-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202D00000X |
| Additional Taxonomies | 103TE1100X Psychologist Exercise & Sports |
| 171400000X | |
| 2251S0007X Physical Therapist Sports | |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2023-10-11 |