| NPI | 1467393983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN JACKSON Owner 602-540-7664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2026-04-01 |
| Last Update Date | 2026-04-01 |