| NPI | 1649223306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MIKRUT Owner/President 928-632-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 6486) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 5501005426) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-07-25 |