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Organization
PARAGON HEALTHCARE OF ARIZONA,LLC.
Active
Organization
PARAGON HEALTHCARE OF ARIZONA,LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM W SPEAR (EXECUTIVE DIRECTOR)
(924) 444-8168
Entity
Organization
Contact information
Practice address
2585 S MIRACLE MILE, SUITE 107, BULLHEAD CITY, AZ 86442-7522
(928) 444-8168
(928) 444-8169
Mailing address
2585 MIRACLE MILE, SUITE 107, BULLHEAD CITY, AZ 86442-7522
(928) 444-8168
(928) 444-8169
Taxonomy
Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z141280
MEDICARE PTAN
AZ
Enumeration date
08/27/2009
Last updated
11/03/2011
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