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Organization
WELL STREET
Active
Organization
WELL STREET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON PAUL MARINO PT, DPT (FOUNDER)
(480) 209-4844
Entity
Organization
Contact information
Practice address
10200 N 92ND ST, SUITE # 110, SCOTTSDALE, AZ 85258-4534
(480) 209-4844
(480) 284-5433
Mailing address
16534 E GLENBROOK BLVD, FOUNTAIN HILLS, AZ 85268-2302
(480) 209-4844
(480) 284-5433
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
5898
AZ
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
02/03/2009
Last updated
04/21/2009
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