Organization
IDEAL REHABILITATION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL R BRAUNING MPT, ATC, MTC (OWNER)
(480) 222-0655
Entity
Organization
Contact information
Practice address
805 N DOBSON RD, SUITE 105, MESA, AZ 85201-7661
(480) 222-0655
(480) 222-1457
Mailing address
PO BOX 269084, OKLAHOMA CITY, OK 73126-9084
(480) 222-0655
(480) 222-1457
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321756
—
AZ
Enumeration date
02/12/2008
Last updated
04/17/2013
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