Basic Information
| Provider Information | |||||||||
| NPI: | 1639203995 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MWR PHYSICAL THERAPY INC | ||||||||
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| OtherOrganizationName: | RESOTRE PHYSICAL THERAPY AND SPORTS MEDICINE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7400 S POWER RD BLDG 3 STE 112 | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852979282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806825460 | ||||||||
| FaxNumber: | 4806825465 | ||||||||
| Practice Location | |||||||||
| Address1: | 7400 S POWER RD BLDG 3 STE 112 | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852979282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806825460 | ||||||||
| FaxNumber: | 4806825465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 12/31/2007 | ||||||||
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| AuthorizedOfficialLastName: | LINDLEY | ||||||||
| AuthorizedOfficialFirstName: | JAIME | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4809806288 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 7101A | AZ | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 2255A2300X | 0080 | AZ | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | 225100000X | 5220 | AZ | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.