| NPI | 1912144015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOLAN RAOUL SHIFREN Owner/Administrator 520-572-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5624) |
| Enumeration Date | 2009-01-11 |
| Last Update Date | 2021-02-07 |