# MOUNTAIN WEST REHABILITATION MEDICINE PLLC

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

## Provider details

- **NPI number:** 1821433152
- **Authorized official:** RICHARD J KOVAN MD (OWNER / PHYSICIAN)
- **Authorized official phone:** (407) 797-3913

## Contact information

- **Practice address:** 255 W BROWN RD, MESA, AZ 85201-3404
- **Practice address phone:** (480) 833-3988
- **Practice address fax:** (480) 962-1996
- **Mailing address:** PO BOX 678290, DALLAS, TX 75267-8290
- **Mailing address phone:** (877) 749-7428
- **Mailing address fax:** (281) 724-3100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 45968 | AZ | Yes |

## Other

- **Enumeration date:** 04/30/2013
- **Last updated:** 04/30/2013