| NPI | 1679384358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN IAN WELLER Owner 480-874-6808 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-01-14 |