| NPI | 1861820508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA POLONI Office Manager 480-883-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 8637) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2024-04-23 |