Organization
ELITE PHYSICAL THERAPY AND PILATES REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LEIGH BANCALE PTA (PHYSICAL THERAPIST ASSISTAN)
(800) 391-9477
Entity
Organization
Contact information
Practice address
2851 S AVENUE B STE 2402, YUMA, AZ 85364-7726
(928) 276-4178
(928) 276-4172
Mailing address
2851 S AVENUE B STE 2402, YUMA, AZ 85364-7726
(800) 391-9477
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
10760A
AZ
Other
Enumeration date
12/14/2013
Last updated
08/01/2014
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