Organization
CHILD INSPIRED THERAPIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDALYNE ROMA PT (OWNER/PHYSICAL THERAPIST)
(928) 301-0762
Entity
Organization
Contact information
Practice address
1540 E RIDGEVIEW DR, COTTONWOOD, AZ 86326-6506
(928) 301-0762
Mailing address
1540 E RIDGEVIEW DR, COTTONWOOD, AZ 86326-6506
(928) 301-0762
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
Update your record
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