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Organization

KIDS INSTRUCTION FOR DEVELOPMENTAL SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEANINE TERESA LANGENBACH P.T. (OWNER)
(602) 380-6761
Entity
Organization

Contact information

Practice address
726 W AIRE LIBRE AVE, PHOENIX, AZ 85023-7910
(602) 380-6761
(602) 938-9839
Mailing address
726 W AIRE LIBRE AVE, PHOENIX, AZ 85023-7910
(602) 380-6761
(602) 938-9839

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1829
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
187240
AZ
Enumeration date
04/17/2007
Last updated
06/11/2008
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