Organization
ADVANCED NEUROLOGIC REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERSON WAYNE HOLM PT, DPT (OWNER)
(480) 699-4845
Entity
Organization
Contact information
Practice address
3160 N. ARIZONA AVE, SUITE 106, CHANDLER, AZ 85225
(480) 699-4845
(480) 699-5085
Mailing address
3160 N. ARIZONA AVE, SUITE 106, CHANDLER, AZ 85225
(480) 699-4845
(480) 699-5085
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
9343
AZ
Other
Enumeration date
07/17/2015
Last updated
07/28/2020
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