| NPI | 1508189853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZANE LARSON LARSON Member 928-526-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 5758) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: AZ 5758) | |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2019-01-16 |