| NPI | 1457638603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA F. BOCK Managing Member 480-726-2287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 7047150001) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2017-12-08 |