Organization
MODERN SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA ADAMS (DIRECTOR OF REVENUE)
(480) 306-6627
Entity
Organization
Contact information
Practice address
1840 E WARNER RD STE 121, TEMPE, AZ 85284-3445
(480) 878-4806
(480) 840-1672
Mailing address
1840 E WARNER RD STE 121, TEMPE, AZ 85284-3445
(480) 878-4806
(480) 840-1672
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
225100000X
Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
08/06/2020
Last updated
09/26/2024
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