Organization · NPI-2

Ahwatukee Sports And Spine Plc

Physical Medicine & Rehabilitation · Phoenix, AZ

NPI number1487610218
StatusActive
Last updated in NPPESOct 26, 2010

Details

NPI
1487610218
Entity type
Organization (NPI-2)
Legal business name
Ahwatukee Sports And Spine Plc
Organization subpart
No
Enumeration date
Apr 21, 2006
Last updated
Oct 26, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation––Yes

Practice location

4530 East Muirwood Drive
Ste 110
Phoenix, AZ 85048

Phone 480-763-5808 · Fax 480-759-0647

Mailing address

Po Box 52817
Phoenix, AZ 85072-2817

Phone 480-763-5808 · Fax 480-759-0647

Authorized official

John M Kozak
President
4807635808

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physical Medicine & Rehabilitation providers in Phoenix, AZ