# SUPPLEMENTAL HEALTHCARE

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

## Provider details

- **NPI number:** 1508004219
- **Authorized official:** MARJORIE KINDER (PHYSICAL THERAPIST)
- **Authorized official phone:** (602) 567-9881

## Contact information

- **Practice address:** 4720 E COTTON GIN LOOP, STE. 140, PHOENIX, AZ 85040-8858
- **Practice address phone:** (602) 567-9881
- **Mailing address:** 4720 E. COTTON GIN LOOP, STE. 140, PHOENIX, AZ 85040
- **Mailing address phone:** (602) 567-9881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 273Y00000X | Rehabilitation Hospital Unit | 3470 | AZ | Yes |

## Other

- **Enumeration date:** 02/03/2009
- **Last updated:** 02/03/2009