| Organization Name: | SPOONER REHAB, PC |
| NPI Number: | 1225472533 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SYLVIA MENDOZA (CREDENTIALING COORDINATOR) |
| Mailing Address: | 13352 N 83rd Ave Suite A-101 Peoria |
| State: | AZ US |
| Postal Code: | 853814158 |
| Phone Number: | 6239798900 |
| Fax Number: | 6239791809 |
| NPI Enumeration Date: | 04/18/2013 |
| NPI Last Update Date: | 06/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |