MEDICARE: MARK A RHODEY M.S.P.T.

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
1	2251S0007X	Sports Physical Therapist
2	2251X0800X	Orthopedic Physical Therapist
3	225100000X	Physical Therapist	5777	AZ

General Provider Information

NPI Number	:	1417048364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A RHODEY M.S.P.T.

Provider Business Mailing Address
First Line	:	14287 N 87TH ST STE 220
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-3698
Country	:	US
Telephone Number	:	480-860-4298
Fax Number	:	480-860-0356

Provider Business Practice Location Address
First Line	:	1847 W HEATHERBRAE DR
Second Line	:	SUITE B
City	:	PHOENIX
State	:	AZ
Zip	:	85015-4764
Country	:	US
Telephone Number	:	602-285-0949
Fax Number	:	602-285-0052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	03/01/2022

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