Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

South Mountain Rehabilitation PC

Organization Chiropractor · NPI 1124176342

South Mountain Rehabilitation PC provides Chiropractor services in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2007.

Licensed in
AZ
In the registry since
2007
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4804 E Chandler Blvd 106
Phoenix, AZ 85048-0857 Not confirmed with CMS for 18 years — call before visiting
Phone: (480) 893-6020
Fax: (480) 785-5161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence 5302 (AZ)
Physical Therapist Taxonomy 225100000X · Licence 2853 (AZ)

Record details

NPI number1124176342
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peter Pakulis — President · (480) 759-1082
NPI enumeratedJanuary 5, 2007
Last updated in NPPESJanuary 3, 2008
Mailing address16016 S 45th Pl, Phoenix, AZ 85048-7635

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