| NPI | 1730372194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK SORRENTINO Statutory Agent 480-247-9063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7796) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 9312PT) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2017-04-17 |