| NPI | 1780114033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY VANHOVE CEO 602-300-9273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2018-03-17 |