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General NPI Number Information
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NPI Number | 1073129698
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Entity Type | Organization
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Legal Business Name | DYNAMIC PERFORMANCE AND RECOVERY, LLC
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 7800 E PIERCE ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85257-4606
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Country | US
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Telephone | 505-235-3290
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 E CALAVAR RD
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City | PHOENIX
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State | AZ
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Zip | 85032-5674
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Country | US
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Telephone | 505-235-3290
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | ASHLEY CHURCH
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Credential | PT, DPT
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Telephone | 505-235-3290
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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 |
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License Number State |
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