| NPI | 1750054631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM ROSSIE Manager 602-881-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2022-05-24 |