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General NPI Number Information
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NPI Number | 1881850329
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Entity Type | Organization
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Legal Business Name | ROCKING HORSES PLLC
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 1250 W KELLY DR
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City | PRESCOTT
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State | AZ
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Zip | 86305-8628
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Country | US
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Telephone | 928-830-0322
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Fax | 928-778-1779
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Provider Business Mailing Address
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Address Line | 1250 W KELLY DR
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City | PRESCOTT
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State | AZ
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Zip | 86305-8628
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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 | PRESIDENT
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Name | MRS. DENISE MARIE ELDRED
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Credential | PHYSICAL THERAPIST
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Telephone | 928-830-0322
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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 | 7171
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License Number State | AZ
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