Organization
PHOENIX PHYSICAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HANSEN D.C (OWNER)
(602) 437-2225
Entity
Organization
Contact information
Practice address
3220 E BASELINE RD STE 112, PHOENIX, AZ 85042-7110
(602) 437-2225
Mailing address
3220 E BASELINE RD STE 112, PHOENIX, AZ 85042-7110
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3918
AZ
Other
Enumeration date
02/08/2013
Last updated
04/04/2013
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