Organization
FOOTHILLS SPORTS MEDICINE & REHABILITATION - EAST VALLEY INC
Active
Other names
Foothills Sports Medicine & Rehabilitation - Gilbert-Mesa
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BASTEN (OWNER)
(480) 689-5515
Entity
Organization
Contact information
Practice address
1702 S VAL VISTA DR STE 107, MESA, AZ 85204-7304
(480) 505-8140
(480) 505-8145
Mailing address
15410 S MOUNTAIN PKWY, SUITE 112, PHOENIX, AZ 85044-6691
(480) 706-1161
(480) 706-7997
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
07/28/2010
Last updated
12/31/2020
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