NPI | 1518774553 |
---|---|
Entity Type | Organization |
Authorized Contact | NATHAN IAN WELLER Owner 480-874-6808 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2024-12-13 |
Last Update Date | 2024-12-13 |