| Organization Name: | SOUTH MOUNTAIN REHABILITATION P.C. |
| NPI Number: | 1124176342 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETER VINCENT PAKULIS (PRESIDENT) |
| Mailing Address: | 4804 E Chandler Blvd 106 Phoenix |
| State: | AZ US |
| Postal Code: | 850480857 |
| Phone Number: | 4808936020 |
| Fax Number: | 4807855161 |
| NPI Enumeration Date: | 01/05/2007 |
| NPI Last Update Date: | 01/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2853 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |