Organization
NEURO INSTITUTE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN OVETA FONSECA (CHIEF ADMINISTRATIVE OFFICER)
(480) 735-0124
Entity
Organization
Contact information
Practice address
1221 W WARNER RD, SUITE 102, TEMPE, AZ 85284-1906
(480) 735-0124
(480) 735-0126
Mailing address
1221 W WARNER RD, SUITE 102, TEMPE, AZ 85284-1906
(480) 735-0124
(480) 735-0126
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
OTC 3407
AZ
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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