Organization
CAMP VERDE PHYSICAL REHABILTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN M PACE MPT (OWNER)
(928) 567-0987
Entity
Organization
Contact information
Practice address
522 WEST FINNEY FLATS RD, SUITE D, CAMP VERDE, AZ 86322
(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
09/05/2006
Last updated
08/22/2020
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