Organization
FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - RED MOUNTAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BASTEN (OWNER)
(480) 689-5515
Entity
Organization
Contact information
Practice address
1066 N POWER RD STE 104-105, MESA, AZ 85205-5709
(480) 481-2244
Mailing address
15410 S MOUNTAIN PKWY STE 112, PHOENIX, AZ 85044-6691
(480) 706-1161
(480) 706-7997
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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