Provider Demographics
NPI:1003411372
Name:ARIZONA MOBILE OUTPATIENT REHAB PLLC
Entity Type:Organization
Organization Name:ARIZONA MOBILE OUTPATIENT REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:520-275-3327
Mailing Address - Street 1:7672 E LOGAN PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-3425
Mailing Address - Country:US
Mailing Address - Phone:520-275-3327
Mailing Address - Fax:
Practice Address - Street 1:7672 E LOGAN PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-3425
Practice Address - Country:US
Practice Address - Phone:520-275-3327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty