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General NPI Number Information
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NPI Number | 1306959218
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Entity Type | Organization
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Legal Business Name | CENTER FOR PHYSICAL MEDICINE & REHABILITATION P C
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 7600 N 15TH ST STE 102
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City | PHOENIX
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State | AZ
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Zip | 85020-4330
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Country | US
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Telephone | 602-246-7410
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Fax | 602-246-7950
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Provider Business Mailing Address
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Address Line | 1331 N 7TH ST STE 360
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City | PHOENIX
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State | AZ
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Zip | 85006-2772
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Country | US
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Telephone | 602-246-9002
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Fax | 602-246-7950
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | KEVIN S LADIN
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Credential | MD
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Telephone | 602-246-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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