Organization
PHYSICAL MEDICINE OF ARIZONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL HIRST (OWNER)
(480) 822-7638
Entity
Organization
Contact information
Practice address
2181 E PECOS RD, SUITE 1, CHANDLER, AZ 85225-6140
(480) 822-7638
Mailing address
422 E HAROLD DR, SAN TAN VALLEY, AZ 85140-5689
(480) 822-7638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
AZ
207QS0010X
Sports Medicine (Family Medicine) Physician
—
AZ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
AZ
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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