| Doctor Name: | VIVIAN M PACE |
| NPI Number: | 1790887255 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | 2149 |
| Business Practice Address: | 522 W Finnie Flats Rd Ste D Camp Verde, AZ - 863227265 |
| Business Phone Number: | 9285670987 |
| Business Fax Number: | 9285675562 |
| Mailing Address: | Po Box 3748, CAMP VERDE |
| State: | AZ |
| Postal Code: | 863223748 |
| Phone Number: | 9285670987 |
| Fax Number: | 9285675562 |
| NPI Enumeration Date: | 09/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 2149 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |