Mountainside Fitness Acquisitions, LLC
Organization Active NPI Sports Medicine (Physical Medicine & Rehabilitation) Physician · Glendale, AZ
NPI 1639769649 · NPPES record last updated Jan 23, 2021
Key facts
- NPI
- 1639769649
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X
- Legal business name
- MOUNTAINSIDE FITNESS ACQUISITIONS, LLC
- Practice address
- 2020 N. 75TH Avenue
Glendale, AZ 85308 - Phone
- (480) 625-0228
- NPI assigned
- Jan 23, 2021
- Organization subpart
- No
Authorized official
- Name
- Eileen Ahern
- Title
- Credentialist
- Phone
- (800) 954-1800
Corporate family (same tax ID) 16
National Provider Directory
- Tax ID family
- Mountainside Fitness Acquisitions LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician |
2081S0010X | Yes |
Addresses
Primary practice location
2020 N. 75TH Avenue
Glendale, AZ 85308
Mailing address
7135 E Camelback Rd
Scottsdale, AZ 85251-1262
Phone (480) 706-8963
Other providers in Glendale, AZ
- Linda L. Motsch
- Thea Marie Motyka
- Sahar Moulaiy
- Mountain Park Health Center
- Mountain Ridge Counseling
- Junnesh Moushi
- Moving Mountain Supportive Housing
- Vaughn Anthony Movses
- Varuzhan Movsesyan
- Stephanie J Mower
All providers in Glendale, AZ · Sports Medicine (Physical Medicine & Rehabilitation) Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.