Organization
REHAB SPECIALISTS OUTPATIENT LLC
Active
Parent organization
REHAB SPECIALISTS OUTPATIENT LLC
Other names
AgeSTRONG Mirabella ASU
Organization subpart
Yes
Provider details
NPI number
Legal business name
REHAB SPECIALISTS OUTPATIENT LLC
Authorized official
PHILLIP G FOGG JR. (OWNER)
(971) 206-5200
Entity
Organization
Contact information
Practice address
65 E UNIVERSITY DR, TEMPE, AZ 85281-1091
(971) 206-5200
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/25/2021
Last updated
08/28/2025
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