Individual
VIVIAN M PACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
522 W FINNIE FLATS RD STE D, CAMP VERDE, AZ 86322-7265
(928) 567-0987
(928) 567-5562
Mailing address
PO BOX 3748, CAMP VERDE, AZ 86322-3748
(928) 567-0987
(928) 567-5562
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2149
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131904
—
AZ
Enumeration date
09/03/2006
Last updated
07/08/2007
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