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General NPI Number Information
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NPI Number | 1932273109
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Entity Type | Organization
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Legal Business Name | FUSION REHABILITATION PLLC
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 2418 E DANBURY RD
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City | PHOENIX
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State | AZ
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Zip | 85032-2425
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Country | US
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Telephone | 602-569-5656
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Fax | 602-569-6119
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Provider Business Mailing Address
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Address Line | 2418 E DANBURY RD
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City | PHOENIX
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State | AZ
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Zip | 85032-2425
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Country | US
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Telephone | 602-569-5656
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Fax | 602-569-6119
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Authorized Official
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Title or Position | MANAGER
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Name | JONATHAN ISAAC SCHIBEL
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Credential | PT
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Telephone | 602-569-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5893
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5435
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License Number State | AZ
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