Individual
KEIKHOSROW MOSALLAIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2610 N 3RD ST, STE B, PHOENIX, AZ 85004
(602) 274-7600
(602) 274-7555
Mailing address
1432 S DOBSON RD, STE 201, MESA, AZ 85202
(602) 274-7600
(602) 274-7555
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4455
AZ
208100000X
Physical Medicine & Rehabilitation Physician
L9821
TX
Other
Enumeration date
04/06/2006
Last updated
06/22/2012
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