Provider Demographics
NPI:1235455957
Name:EXOS AP ARIZONA, LLC
Entity type:Organization
Organization Name:EXOS AP ARIZONA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GODIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:207-232-8692
Mailing Address - Street 1:2629 E ROSE GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4605
Mailing Address - Country:US
Mailing Address - Phone:602-971-2222
Mailing Address - Fax:602-971-0329
Practice Address - Street 1:2629 E ROSE GARDEN LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4605
Practice Address - Country:US
Practice Address - Phone:602-971-2222
Practice Address - Fax:602-971-0329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHLETES PERFORMANCE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-20
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty