| NPI | 1760963060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA PECK-DEVENPORT Billing Manager 623-236-2545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 4222) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-08-24 |