Organization
SUPPLEMENTAL HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE SMITH (OCCUPATIONAL THERAPY ASSISTANT)
(602) 567-9881
Entity
Organization
Contact information
Practice address
4720 E COTTON GIN LOOP, PHOENIX, AZ 85040-4823
(602) 567-9881
Mailing address
4720 E COTTON GIN LOOP, PHOENIX, AZ 85040-4823
(602) 567-9881
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
4186
AZ
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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