Provider Demographics
NPI:1861699662
Name:FLORA WALKING INSTITUTE, INCORPORATED
Entity type:Organization
Organization Name:FLORA WALKING INSTITUTE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSPT
Authorized Official - Prefix:
Authorized Official - First Name:KANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-632-2920
Mailing Address - Street 1:1410 W GUADALUPE RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3003
Mailing Address - Country:US
Mailing Address - Phone:480-632-2920
Mailing Address - Fax:480-632-2923
Practice Address - Street 1:1410 W GUADALUPE RD
Practice Address - Street 2:SUITE 117
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3003
Practice Address - Country:US
Practice Address - Phone:480-632-2920
Practice Address - Fax:480-632-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6553174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty