Organization
WING NEUROLOGICAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY K. WING (OWNER)
(602) 393-0520
Entity
Organization
Contact information
Practice address
1190 E MISSOURI AVE STE 100, PHOENIX, AZ 85014-2719
(480) 567-6717
Mailing address
1190 E MISSOURI AVE. SUITE 100, PHOENIX, AZ 85014
(480) 567-6717
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
TSLP7413
AZ
Other
Enumeration date
08/31/2011
Last updated
09/16/2011
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