Organization Name: | PHYSIOTHERAPY ASSOCIATES, INC. |
NPI Number: | 1114006632 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL E. TARVIN (VICE PRESIDENT) |
Mailing Address: | 13055 W. Mcdowell Rd Bldg G Ste107 Avondale |
State: | AZ US |
Postal Code: | 853236450 |
Phone Number: | 6235474787 |
Fax Number: | 6235474788 |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | OTC3612 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |