Basic Information
| Provider Information | |||||||||
| NPI: | 1003358607 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARIS HEALTH CORP | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ARIS PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17100 N 67TH AVE BLDG 1 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853083605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239792747 | ||||||||
| FaxNumber: | 6239793122 | ||||||||
| Practice Location | |||||||||
| Address1: | 17100 N 67TH AVE BLDG 1 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853083605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239792747 | ||||||||
| FaxNumber: | 6239793122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2016 | ||||||||
| LastUpdateDate: | 11/14/2016 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | PAULINE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6239792747 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | OTC4195 | AZ | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.