Organization
SPORTS CONDITIONING CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT JAMES BOCCHICCHIO PH D (DIRECTOR)
(602) 224-5724
Entity
Organization
Contact information
Practice address
2394 E CAMELBACK RD, STE 120, PHOENIX, AZ 85016-3429
(602) 224-5724
Mailing address
2394 E CAMELBACK RD, STE 120, PHOENIX, AZ 85016-3429
(602) 224-5724
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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