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Organization

ACCIDENT & INJURY SOLUTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOJO DEGROOT (ADMINISTRATOR)
(602) 466-9664
Entity
Organization

Contact information

Practice address
701 W GLENDALE AVE, PHOENIX, AZ 85021-8629
(602) 466-9664
(602) 391-2617
Mailing address
PO BOX 75573, PHOENIX, AZ 85087-1029
(602) 466-9664
(602) 391-2617

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
4105
AZ
207QS0010X
Sports Medicine (Family Medicine) Physician
4105
AZ
208D00000X
General Practice Physician
Primary

Other

Enumeration date
10/16/2017
Last updated
10/16/2017
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