Organization
FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - GLENDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BASTEN (OWNER)
(480) 689-5515
Entity
Organization
Contact information
Practice address
19420 N 59TH AVE STE H830, GLENDALE, AZ 85308-6980
(623) 302-9020
Mailing address
15410 S MOUNTAIN PKWY STE 112, PHOENIX, AZ 85044-6691
(480) 706-1161
(480) 706-7997
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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