| NPI | 1891315446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN GILLEN Member 480-633-3151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |