Organization
FLAGSTAFF PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WAYNE STATHAM PT (OWNER PRESIDENT)
(928) 773-1601
Entity
Organization
Contact information
Practice address
715 N BEAVER ST, FLAGSTAFF, AZ 86001
(928) 773-1601
(928) 773-1603
Mailing address
715 N BEAVER ST, FLAGSTAFF, AZ 86001
(928) 773-1601
(928) 773-1603
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
AZ
Other
Enumeration date
06/08/2005
Last updated
05/13/2008
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