| |
3145 N Dysart Rd Ste 109, Avondale, AZ 85392-6802 | |
(623) 522-8491 | |
(623) 522-8492 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center |
Location | 3145 N Dysart Rd Ste 109, Avondale, Arizona |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306369905 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (Arizona) | Secondary |
225X00000X | Occupational Therapist | (Arizona) | Secondary |
261Q00000X | Clinic/center | (Arizona) | Primary |
Mailing Address | Practice Location Address |
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625 Enterprise Dr, Oak Brook, IL 60523-8813 Ph: (630) 575-1980 | 3145 N Dysart Rd Ste 109, Avondale, AZ 85392-6802 Ph: (623) 522-8491 |