| NPI | 1659796985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY KERSTEN Owner/Provider 602-956-2095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 202K00000X Phlebology |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2014-08-15 |