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Organization
WING NEUROLOGICAL REHABILITATION
Active
Organization
WING NEUROLOGICAL REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHERINE WING PT (OWNER)
(602) 393-0520
Entity
Organization
Contact information
Practice address
1190 E MISSOURI AVE, SUITE 100, PHOENIX, AZ 85014-2734
(602) 393-0520
(602) 393-0523
Mailing address
1190 E MISSOURI AVE, SUITE 100, PHOENIX, AZ 85014-2734
(602) 393-0520
(602) 393-0523
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
05/22/2006
Last updated
10/18/2011
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