| NPI | 1639211519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TERRY MCKENNEY Athletic Trainer 602-437-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 0076) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |