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General NPI Number Information
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NPI Number | 1336879873
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Entity Type | Organization
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Legal Business Name | ARIZONA LYMPHEDEMA INSTITUTE
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 8771 N HUCKELBERRY WAY
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City | TUCSON
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State | AZ
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Zip | 85742-4179
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Country | US
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Telephone | 760-406-2681
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Fax |
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Provider Business Mailing Address
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Address Line | 8771 N HUCKELBERRY WAY
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City | TUCSON
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State | AZ
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Zip | 85742-4179
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Country | US
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Telephone | 760-406-2681
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Fax |
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Authorized Official
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Title or Position | CEO AND OWNER
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Name | MR. MARK D SCHMIDT
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Credential |
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Telephone | 760-406-2681
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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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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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