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General NPI Number Information
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NPI Number | 1437421211
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Entity Type | Organization
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Legal Business Name | AQUATIC N WRITING REHAB
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 12355 W COCOPAH ST
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City | AVONDALE
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State | AZ
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Zip | 85323-3120
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Country | US
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Telephone | 480-213-4682
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Fax |
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Provider Business Mailing Address
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Address Line | 12355 W COCOPAH ST
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City | AVONDALE
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State | AZ
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Zip | 85323-3120
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Country | US
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Telephone | 480-213-4682
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. MICHELLE TURNER
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Credential | PT, DPT
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Telephone | 480-213-4682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | AZ
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