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NPI Code Detail

MEDICARE: CAMELBACK SPORTS THERAPY LLC

MEDICARE: CAMELBACK SPORTS THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1255426318
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMELBACK SPORTS THERAPY LLC
Provider Business Mailing Address
First Line : PO BOX 44767
Second Line :
City : PHOENIX
State : AZ
Zip : 85064-4767
Country : US
Telephone Number : 602-808-8989
Fax Number : 602-808-9494
Provider Business Practice Location Address
First Line : 4800 N 44TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-3800
Country : US
Telephone Number : 602-808-8989
Fax Number : 602-808-9494
Authorized Official
Title or Position : OWNER
Name : MS. NATALIE JANE SEMON
Credential : PT
Telephone Number : 602-808-8989
Provider Enumeration Date : 10/04/2006
Last Update Date : 10/11/2023

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Directions to “CAMELBACK SPORTS THERAPY LLC ” Practice Location

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