| NPI | 1871998799 |
|---|---|
| Doing Business As | HISTORIC MESA OUTPATIENT REHAB CLINIC |
| Entity Type | Organization |
| Authorized Contact | KATHY LOSCHEIDER Executive Director 602-443-5439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ OTC5456) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: AZ OTC5456) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |