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NPI 1821226762

NPI 1821226762 : TINA MARIE RUMBY FISK OTR/L : PHOENIX, AZ

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General NPI Number Information
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    NPI Number           |    1821226762
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    Entity Type          |    Individual 
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    Provider Name        |    TINA MARIE RUMBY FISK OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/30/2009
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    Last Update Date     |    06/30/2009
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Provider Practice Location Address
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    Address Line         |    3108 W JOMAX RD 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85083-8643
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    Country              |    US
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    Telephone            |    480-593-6933
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    Fax                  |    623-388-3998
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Provider Business Mailing Address
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    Address Line         |    3108 W JOMAX RD 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85083-8643
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    Country              |    US
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    Telephone            |    480-593-6933
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    Fax                  |    623-388-3998
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    0132
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    License Number State |    AZ
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