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General NPI Number Information
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NPI Number | 1568019735
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Entity Type | Organization
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Legal Business Name | DYNAMIC PERFORMANCE
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 9475 E IRONWOOD SQUARE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4576
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Country | US
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Telephone | 480-778-1400
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Fax | 480-778-0400
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Provider Business Mailing Address
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Address Line | 9393 N 90TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5040
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | SABRINA WALL
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Credential |
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Telephone | 480-748-1702
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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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