MEDICARE: MEDI-SSAGE HEALTH INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172M00000X	Mechanotherapist
2	261Q00000X	Clinic/Center
3	261QP3300X	Pain Clinic/Center
4	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1093353427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDI-SSAGE HEALTH INC.

Provider Business Mailing Address
First Line	:	1480 E PECOS RD APT 2038
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85295-1838
Country	:	US
Telephone Number	:	480-479-5003
Fax Number	:	480-546-5199

Provider Business Practice Location Address
First Line	:	555 N 18TH ST STE 301
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-3759
Country	:	US
Telephone Number	:	480-770-4606
Fax Number	:	480-546-5199

Authorized Official
Title or Position	:	ED & FOUNDER
Name	:	ARRICKA WATKINS
Credential	:	LMT,MMP,PSS
Telephone Number	:	480-770-4606

Provider Enumeration Date	:	12/17/2019
Last Update Date	:	04/30/2024

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