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NPI Code Detail

MEDICARE: MONA A HOLUBAR PT

MEDICARE:   MONA A HOLUBAR  PT
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 Therapist8786AZ

General Provider Information

NPI Number : 1356673636
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONA A HOLUBAR PT
Provider Business Mailing Address
First Line : 750 E THUNDERBIRD RD
Second Line : SUITE 1
City : PHOENIX
State : AZ
Zip : 85022-5306
Country : US
Telephone Number : 602-866-1255
Fax Number : 602-863-7713
Provider Business Practice Location Address
First Line : 750 E THUNDERBIRD RD
Second Line : SUITE 1
City : PHOENIX
State : AZ
Zip : 85022-5306
Country : US
Telephone Number : 602-866-1255
Fax Number : 602-863-7713
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2010
Last Update Date : 02/16/2011

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Directions to “ MONA A HOLUBAR PT” Practice Location

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