Organization
GROWING SPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOURNE DOMEK OTL (OCCUPATIONAL THERAPIST)
(480) 347-8265
Entity
Organization
Contact information
Practice address
3940 S 79TH DR, PHOENIX, AZ 85043-1694
(480) 347-8265
Mailing address
3940 S 79TH DR, PHOENIX, AZ 85043-1694
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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