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General NPI Number Information
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NPI Number | 1154832277
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Entity Type | Organization
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Legal Business Name | ACCIDENT & INJURY SOLUTIONS
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 701 W GLENDALE AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-8629
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Country | US
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Telephone | 602-466-9664
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Fax | 602-391-2617
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Provider Business Mailing Address
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Address Line | PO BOX 75573
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City | PHOENIX
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State | AZ
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Zip | 85087-1029
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Country | US
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Telephone | 602-466-9664
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Fax | 602-391-2617
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOJO DEGROOT
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Credential |
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Telephone | 602-466-9664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Neuromusculoskeletal Medicine, Sports Medicine
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License Number | 4105
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine
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License Number | 4105
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice
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License Number |
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License Number State |
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