Provider Demographics
NPI:1629761796
Name:PHYSICAL MEDICINE LLC
Entity Type:Organization
Organization Name:PHYSICAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-889-7398
Mailing Address - Street 1:15396 N 83RD AVE STE C101
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-5627
Mailing Address - Country:US
Mailing Address - Phone:623-889-7398
Mailing Address - Fax:
Practice Address - Street 1:15396 N 83RD AVE STE C101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5627
Practice Address - Country:US
Practice Address - Phone:623-889-7398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty