Foothills Sports Medicine & Rehabilitation - East Valley INC
Physical Therapist in Mesa, AZ. Organization (NPI-2).
NPI number1881908192
StatusActive
Last updated in NPPESDec 31, 2020
Details
- NPI
- 1881908192
- Entity type
- Organization (NPI-2)
- Legal business name
- Foothills Sports Medicine & Rehabilitation - East Valley INC
- Organization subpart
- No
- Enumeration date
- Jul 28, 2010
- Certification date
- Dec 31, 2020
- Last updated
- Dec 31, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 2251S0007X | Physical Therapist, Sports | – | – | |
| 2251X0800X | Physical Therapist, Orthopedic | – | – |
Other names
- Foothills Sports Medicine & Rehabilitation - Gilbert-Mesa (Doing Business As)
Practice location
1702 S Val Vista Dr Ste 107Mesa, AZ 85204-7304
Phone 480-505-8140 · Fax 480-505-8145
Mailing address
15410 S Mountain PkwySuite 112
Phoenix, AZ 85044-6691
Phone 480-706-1161 · Fax 480-706-7997
Authorized official
Michael Basten
Owner
4806895515
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