Organization
ELITE SPORTS THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL WILLIAM RAE D.C. (MEDICAL DIRECTOR/OWNER)
(480) 390-1962
Entity
Organization
Contact information
Practice address
1184 N GILBERT RD STE 100, GILBERT, AZ 85234-2476
(480) 390-1962
Mailing address
1184 N GILBERT RD STE 100, GILBERT, AZ 85234-2476
(480) 390-1962
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
8028
AZ
261QR0400X
Rehabilitation Clinic/Center
Primary
8028
AZ
Other
Enumeration date
04/28/2009
Last updated
04/28/2009
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