| NPI | 1841795028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN GILLEN Manager 480-633-3151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| 207RS0010X Internal Medicine, Sports Medicine | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |