Organization
LONGEVITY PT & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BERRY DPT (OWNER)
(801) 636-3676
Entity
Organization
Contact information
Practice address
4448 E MAIN ST STE 1, MESA, AZ 85205-7916
(480) 696-3545
(480) 696-5788
Mailing address
4319 N GRANITE REEF RD, SCOTTSDALE, AZ 85251-2832
(801) 636-3676
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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