Healthcare Provider Details
I. General information
NPI: 1467635995
Provider Name (Legal Business Name): ARIZONA REHABILITATION ASSOCIATES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/06/2007
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4550 N 51ST AVE SUITE 5
PHOENIX AZ
85031-1708
US
IV. Provider business mailing address
5620 W THUNDERBIRD RD SUITE G-3
GLENDALE AZ
85306-4636
US
V. Phone/Fax
- Phone: 623-848-8777
- Fax:
- Phone: 602-938-2422
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | OTC 2266 |
| License Number State | AZ |
VIII. Authorized Official
Name:
VALERIE
HOLDEMAN
LEE
Title or Position: PRESIDENT, CEO, PT, CT
Credential:
Phone: 602-938-2422