Organization
PHYSICAL MEDICINE CENTERS OF ARIZONA, LLC
Active
Other names
Laveen Physical Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JEROD BOWEN PT (OWNER)
(602) 237-1105
Entity
Organization
Contact information
Practice address
5045 W BASELINE RD STE 120, SUITE 120, LAVEEN, AZ 85339-7393
(602) 237-1105
(602) 237-1106
Mailing address
5045 W BASELINE RD STE 120, SUITE 120, LAVEEN, AZ 85339-7393
(602) 237-1105
(602) 237-1106
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
11/09/2010
Last updated
03/05/2012
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