Provider Demographics
NPI:1457797615
Name:AFA INSTITUTE
Entity Type:Organization
Organization Name:AFA INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSTITUTE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:480-265-8031
Mailing Address - Street 1:4838 E BASELINE RD STE 126
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4673
Mailing Address - Country:US
Mailing Address - Phone:480-265-8031
Mailing Address - Fax:480-219-6110
Practice Address - Street 1:4838 E BASELINE RD STE 126
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4673
Practice Address - Country:US
Practice Address - Phone:480-265-8031
Practice Address - Fax:480-219-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6215261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy