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Organization
MODERN SPORTS MEDICINE LLC
Active
Organization
MODERN SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA ADAMS (OWNER)
(480) 306-6627
Entity
Organization
Contact information
Practice address
5590 W CHANDLER BLVD STE 4, CHANDLER, AZ 85226-3744
(480) 306-6627
(480) 306-6696
Mailing address
5590 W CHANDLER BLVD STE 4, CHANDLER, AZ 85226-3744
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
06/26/2023
Last updated
09/26/2024
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