| NPI | 1528280146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DOUGLAS ROBERTS Owner Manager 520-884-9819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 4064) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |