MEDICARE: COURTNEY COBLER DPT

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	225100000X	Physical Therapist	31755	AZ

General Provider Information

NPI Number	:	1538734363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY COBLER DPT

Provider Business Mailing Address
First Line	:	34662 N HAPPY JACK DR
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-6654
Country	:	US
Telephone Number	:	208-985-3326
Fax Number	:

Provider Business Practice Location Address
First Line	:	37200 N GANTZEL RD
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-7368
Country	:	US
Telephone Number	:	480-690-8080
Fax Number	:

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

Provider Enumeration Date	:	05/24/2021
Last Update Date	:	05/24/2021

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Directions to “ COURTNEY COBLER DPT” Practice Location

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