# PHYSICAL MEDICINE OF ARIZONA, LLC

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

## Provider details

- **NPI number:** 1740529536
- **Authorized official:** LAUREL HIRST (OWNER)
- **Authorized official phone:** (480) 822-7638

## Contact information

- **Practice address:** 2181 E PECOS RD, SUITE 1, CHANDLER, AZ 85225-6140
- **Practice address phone:** (480) 822-7638
- **Mailing address:** 422 E HAROLD DR, SAN TAN VALLEY, AZ 85140-5689
- **Mailing address phone:** (480) 822-7638

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | AZ | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | AZ | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | AZ | Yes |

## Other

- **Enumeration date:** 02/13/2013
- **Last updated:** 02/13/2013