Organization
PHYSICAL MEDICINE OF MESA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MOSHIRI (MANAGER)
(602) 441-3573
Entity
Organization
Contact information
Practice address
3614 E SOUTHERN AVE STE 105, MESA, AZ 85206-2510
(602) 354-5310
Mailing address
21001 N TATUM BLVD STE 1630-606, PHOENIX, AZ 85050-4242
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
02/24/2022
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