Basic Information
| Provider Information | |||||||||
| NPI: | 1033394507 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALLEY REHABILITATION ASSOCIATES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20940 N TATUM BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850504265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805025361 | ||||||||
| FaxNumber: | 4805025369 | ||||||||
| Practice Location | |||||||||
| Address1: | 20940 N TATUM BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850504265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805025361 | ||||||||
| FaxNumber: | 4805025369 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2008 | ||||||||
| LastUpdateDate: | 07/27/2009 | ||||||||
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| AuthorizedOfficialLastName: | KRESL | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
| AuthorizedOfficialMiddleName: | RAE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PT | ||||||||
| AuthorizedOfficialTelephone: | 4805025361 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.