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General NPI Number Information
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NPI Number | 1447547401
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Entity Type | Organization
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Legal Business Name | SPA-AAAH AT REGENT HEALTHCARE, INC
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 4110 N SCOTTSDALE RD STE 325
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4423
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Country | US
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Telephone | 480-609-4244
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Fax | 480-609-4382
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Provider Business Mailing Address
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Address Line | 4110 N SCOTTSDALE RD STE 325
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4423
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Country | US
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Telephone | 480-609-4244
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Fax | 480-609-4382
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Authorized Official
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Title or Position | OWNER
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Name | SHAWN M MEYER
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Credential |
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Telephone | 480-234-9436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 4276
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License Number State | AZ
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