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Organization
MOHAVE NEURO REHAB CONSUL PC
Active
Organization
MOHAVE NEURO REHAB CONSUL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS J. PARKS MD (OWNER)
(928) 681-6600
Entity
Organization
Contact information
Practice address
1520 E HAMMER LN, STE 106, FORT MOHAVE, AZ 86426-6664
(928) 681-6600
(928) 681-6606
Mailing address
1520 E HAMMER LN, STE 106, FORT MOHAVE, AZ 86426-6664
(928) 681-6600
(928) 681-6606
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
11/04/2005
Last updated
06/13/2008
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