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03D2142579 CLIA NUMBER - MOUNTAIN MEDICINE INTEGRATIVE WELLNESS CENTER

Laboratory Demographics

CLIA Number: 03D2142579

Facility Name: MOUNTAIN MEDICINE INTEGRATIVE WELLNESS CENTER

Facility Address:
1585 S PLAZA WAY STE 150
FLAGSTAFF, AZ
ZIP 86001
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Facility Phone Number: (928) 226-1556

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver
NPI Number: 1124640131

Taxonomy: 261QP2000X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.

CLIA Record

Field Name Field Value
CLIA Number 03D2142579
LAB Type PHYSICIAN OFFICE
Facility Name MOUNTAIN MEDICINE INTEGRATIVE WELLNESS CENTER
Street 1585 S PLAZA WAY STE 150
City FLAGSTAFF
State AZ
ZIP 86001
Phone (928) 226-1556

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This page was last updated on: 5/11/2023