| NPI | 1801941992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM BENNETCH Owner 928-453-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ otc3718) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2021-04-27 |