| NPI | 1619642170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA KRAWCZYK Owner 602-793-3817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| 111NS0005X Chiropractor Sports Physician | |
| 174400000X Specialist | |
| 204D00000X Neuromusculoskeletal Medicine & OMM | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 225100000X Physical Therapist | |
| 2251P0200X Physical Therapist Pediatrics | |
| 2251S0007X Physical Therapist Sports | |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-16 |