| Mohave Neuro Rehab Consul Pc | |
|
1520 E Hammer Ln Ste 106 Fort Mohave AZ 86426-6664 | |
| (928) 681-6600 | |
| (928) 681-6606 |
| Full Name | Mohave Neuro Rehab Consul Pc |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 1520 E Hammer Ln, Fort Mohave, Arizona |
| Authorized Official Name and Position | Thomas J. Parks (OWNER) |
| Authorized Official Contact | 9286816600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohave Neuro Rehab Consul Pc 1520 E Hammer Ln Ste 106 Fort Mohave AZ 86426-6664 Ph: (928) 681-6600 | Mohave Neuro Rehab Consul Pc 1520 E Hammer Ln Ste 106 Fort Mohave AZ 86426-6664 Ph: (928) 681-6600 |
| NPI Number | 1942291117 |
|---|---|
| Provider Enumeration Date | 11/04/2005 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942291117 | NPI | - | NPPES |
| CE1180 | Other | AZ | RR MEDICARE |
| Z21066 | Other | AZ | MEDICARE PROV # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
Southwest Neurology P C Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5300 S Highway 95, Suite L, Fort Mohave, AZ 86426 Phone: 928-788-4260 Fax: 928-788-4262 | |
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