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NPI Code Detail

MEDICARE: VALLEY PHYSICAL MEDICINE & REHABILITATION, P C

MEDICARE: VALLEY PHYSICAL MEDICINE & REHABILITATION, P C
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z66051OTHERAZMEDICARE PTAN

General Provider Information

NPI Number : 1508819228
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY PHYSICAL MEDICINE & REHABILITATION, P C
Provider Business Mailing Address
First Line : 222 W THOMAS RD
Second Line : STE 114
City : PHOENIX
State : AZ
Zip : 85013
Country : US
Telephone Number : 602-406-6304
Fax Number : 602-406-6302
Provider Business Practice Location Address
First Line : 222 W THOMAS RD STE 114
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4420
Country : US
Telephone Number : 602-406-4578
Fax Number : 602-406-6302
Authorized Official
Title or Position : PRACTICE MANAGER
Name : JENNIFER ANN FRANKS-MITCHELL JAUREGUI
Credential :
Telephone Number : 602-406-4578
Provider Enumeration Date : 05/17/2006
Last Update Date : 10/25/2022

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Directions to “VALLEY PHYSICAL MEDICINE & REHABILITATION, P C ” Practice Location

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