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General NPI Number Information
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NPI Number | 1568720837
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Entity Type | Organization
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Legal Business Name | STELLAR PHYSICAL MEDICINE, PLLC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 9301 E SHEA BLVD STE. 118
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6733
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Country | US
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Telephone | 480-423-3525
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Fax | 866-738-0810
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Provider Business Mailing Address
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Address Line | 9301 E SHEA BLVD STE. 118
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6733
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Country | US
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Telephone | 480-423-3525
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Fax | 866-738-0810
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATHY WRIGHT
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Credential |
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Telephone | 480-423-3525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 34046
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License Number State | AZ
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