Organization · NPI-2

Aesthetica PLLC

Physical Medicine & Rehabilitation, Sports Medicine · Phoenix, AZ

NPI number1174343883
StatusActive
Last updated in NPPESOct 16, 2024

Details

NPI
1174343883
Entity type
Organization (NPI-2)
Legal business name
Aesthetica PLLC
Organization subpart
No
Enumeration date
Oct 16, 2024
Certification date
Oct 16, 2024
Last updated
Oct 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine––Yes
133NN1002X Nutritionist, Nutrition, Education––
224Y00000X Clinical Exercise Physiologist––
261QM1300X Clinic/Center, Multi-Specialty––
261QP2000X Clinic/Center, Physical Therapy––

Practice location

45 E Monterey Way Ste 202
Phoenix, AZ 85012-2757

Phone 602-791-0199

Mailing address

45 E Monterey Way Ste 202
Phoenix, AZ 85012-2757

Phone 602-791-0199

Authorized official

Tiffany Harris
Owner/Ceo
6027910199

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