| NPI | 1588295786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN IAN WELLER Owner 480-874-6808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |