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Organization
PHYSICAL MEDICINE CENTERS OF ARIZONA, LLC
Active
Organization
PHYSICAL MEDICINE CENTERS OF ARIZONA, LLC
Active
Other names
Laveen Physical Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JEROD BOWEN PT (OWNER)
(602) 237-1105
Entity
Organization
Contact information
Practice address
5045 W BASELINE RD STE 120, SUITE 120, LAVEEN, AZ 85339-7393
(602) 237-1105
(602) 237-1106
Mailing address
5045 W BASELINE RD STE 120, SUITE 120, LAVEEN, AZ 85339-7393
(602) 237-1105
(602) 237-1106
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
11/09/2010
Last updated
03/05/2012
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