Organization
IMPACTMEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW COEN DC (DIRECTOR)
(602) 762-1128
Entity
Organization
Contact information
Practice address
701 W GLENDALE AVE, PHOENIX, AZ 85021-8629
(602) 762-1128
Mailing address
7000 N 16TH ST STE 102-201, PHOENIX, AZ 85020-5512
(602) 762-1128
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
11/15/2020
Last updated
11/15/2020
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