# PHOENIX PHYSICAL MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366781452
- **Authorized official:** DAVID HANSEN D.C (OWNER)
- **Authorized official phone:** (602) 437-2225

## Contact information

- **Practice address:** 3220 E BASELINE RD STE 112, PHOENIX, AZ 85042-7110
- **Practice address phone:** (602) 437-2225
- **Mailing address:** 3220 E BASELINE RD STE 112, PHOENIX, AZ 85042-7110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 3918 | AZ | Yes |

## Other

- **Enumeration date:** 02/08/2013
- **Last updated:** 04/04/2013