Organization
FUNCTIONAL PERFORMANCE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK STEVESON (MGR)
(480) 968-2020
Entity
Organization
Contact information
Practice address
2065 S COTTONWOOD DR STE 1, TEMPE, AZ 85282-3040
(480) 968-2020
(480) 968-0404
Mailing address
2065 S COTTONWOOD DR STE 1, TEMPE, AZ 85282-3040
(480) 968-2020
(480) 968-0404
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3665
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0463350
BCBS OF ARIZONA
AZ
Enumeration date
04/27/2006
Last updated
12/03/2025
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