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 |