MEDICARE: ARIZONA NEUROLOGICAL INSTITUTE, PC

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1679904734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA NEUROLOGICAL INSTITUTE, PC

Provider Business Mailing Address
First Line	:	10474 W THUNDERBIRD BLVD
Second Line	:	SUITE 200
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3023
Country	:	US
Telephone Number	:	623-972-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	10474 W THUNDERBIRD BLVD
Second Line	:	SUITE 200
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3023
Country	:	US
Telephone Number	:	623-972-3800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MANINDER KAHLON
Credential	:	MD
Telephone Number	:	623-972-3800

Provider Enumeration Date	:	11/27/2013
Last Update Date	:	11/27/2013

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