Healthcare Provider Details

I. General information

NPI: 1639352164
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

16601 N 40TH ST SUITE 229
PHOENIX AZ
85032-3345
US

IV. Provider business mailing address

5620 W THUNDERBIRD RD SUITE G-3
GLENDALE AZ
85306-4636
US

V. Phone/Fax

Practice location:
  • Phone: 602-482-1096
  • Fax:
Mailing address:
  • Phone: 602-938-2422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberOTC 3141
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: VALERIE HOLDEMAN LEE
Title or Position: PRESIDENT, CEO, PT, CHT
Credential:
Phone: 602-938-2422