| Organization Name: | FOOTHILLS SPORTS MEDICINE & REHABILITATION LITCHFIELD PARK, INC |
| NPI Number: | 1134317779 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC BLASIN (OWNER) |
| Mailing Address: | 5110 N Dysart Rd Suite 148 Litchfield Park |
| State: | AZ US |
| Postal Code: | 853403058 |
| Phone Number: | 6235474739 |
| Fax Number: | 6235362154 |
| NPI Enumeration Date: | 10/09/2007 |
| NPI Last Update Date: | 10/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251S0007X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Sports |
| Taxonomy Definition: | |