Organization
RE-MEDICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MARIE EBERSOLE (OWNER/MANAGER)
(623) 759-1668
Entity
Organization
Contact information
Practice address
6140 W CHANDLER BLVD STE 7, CHANDLER, AZ 85226-3460
(623) 759-1668
Mailing address
6140 W CHANDLER BLVD STE 7, CHANDLER, AZ 85226-3460
(480) 759-1668
(480) 452-0512
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/14/2021
Last updated
01/25/2022
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