Organization
BACK IN ACTION OF SCOTTSDALE LLC
Active
Other names
Back In Action Pain Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH W FANDRY (CLINICAL DIRECTOR)
(480) 513-4801
Entity
Organization
Contact information
Practice address
2340 E BEARDSLEY RD STE 120, PHOENIX, AZ 85024-1286
(480) 513-4801
(480) 513-4867
Mailing address
8711 E PINNACLE PEAK RD PMB 105, SCOTTSDALE, AZ 85255-3517
(480) 513-4801
(480) 513-4867
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
437521
—
AZ
Enumeration date
07/02/2007
Last updated
07/28/2020
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