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NPI Code Detail

MEDICARE: PLR PHYSIATRY, LLC

MEDICARE: PLR PHYSIATRY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1053927665
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLR PHYSIATRY, LLC
Provider Business Mailing Address
First Line : 23002 N LAS LAVATAS RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-4307
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 23002 N LAS LAVATAS RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-4307
Country : US
Telephone Number : 708-296-3710
Fax Number :
Authorized Official
Title or Position : AO
Name : PUNEET RALHAN
Credential :
Telephone Number : 708-296-3710
Provider Enumeration Date : 09/18/2020
Last Update Date : 09/18/2020

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Directions to “PLR PHYSIATRY, LLC ” Practice Location

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