| NPI | 1700495892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA ADAMS Owner 480-306-6627 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2024-09-26 |