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NPI Code Detail

MEDICARE: BETHANY NOVAK

MEDICARE: BETHANY NOVAK
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 Therapist12596AZ

General Provider Information

NPI Number : 1649702630
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY NOVAK
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2223
Fax Number : 630-759-9510
Provider Business Practice Location Address
First Line : 5393 S CALLE SANTA CRUZ STE 107
Second Line :
City : TUCSON
State : AZ
Zip : 85706-3556
Country : US
Telephone Number : 520-225-0129
Fax Number : 520-244-0000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2017
Last Update Date : 03/30/2017

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Directions to “ BETHANY NOVAK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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