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Organization

GENESIS PHYSICAL THERAPY, LLC

Active
Other names
Mesa Health Improvement Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. N. DOUGLAS ANDERSON (PRESIDENT)
(480) 325-8838
Entity
Organization

Contact information

Practice address
6343 E MAIN ST, SUITE 8, MESA, AZ 85205-8954
(480) 325-8838
(480) 325-9191
Mailing address
6343 E MAIN ST, SUITE 8, MESA, AZ 85205-8954
(480) 325-8838
(480) 325-9191

Taxonomy

Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
OTC4110
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200152
AZ
05
698269
AZ
Enumeration date
11/09/2006
Last updated
10/20/2009
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