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General NPI Number Information
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NPI Number | 1033511100
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL INVESTMENTS, PLLC
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Dates
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Enumeration Date | 09/20/2014
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Last Update Date | 09/20/2014
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Provider Practice Location Address
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Address Line | 4303 W VAN BUREN ST STE 4
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City | PHOENIX
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State | AZ
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Zip | 85043-3928
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Country | US
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Telephone | 602-995-0400
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Fax | 602-995-0500
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Provider Business Mailing Address
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Address Line | 4303 W VAN BUREN ST STE 4
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City | PHOENIX
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State | AZ
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Zip | 85043-3928
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Country | US
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Telephone | 602-995-0400
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Fax | 602-995-0500
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. PATRICK O'BRIEN
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Credential | PT, DPT
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Telephone | 602-995-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | P-1870208-5
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License Number State | AZ
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