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General NPI Number Information
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NPI Number | 1861701625
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Entity Type | Organization
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Legal Business Name | LOOK, SEE, MOVE
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 1801 S JENTILLY LN SUITE A4
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City | TEMPE
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State | AZ
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Zip | 85281-5758
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Country | US
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Telephone | 520-401-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 E PARK AVE
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City | PHOENIX
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State | AZ
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Zip | 85044-8255
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Country | US
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Telephone | 520-401-1081
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHAEDRA ANTIOCO
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Credential | OTR/L
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Telephone | 520-401-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 2668
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License Number State | AZ
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