| NPI | 1508175753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ANDREW RICHETTO Chief Treating Physician 480-775-3503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7378) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: AZ 4562) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 4562PT) | |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2011-01-24 |