MEDICARE: BRIAN D ONISKO PTA

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	225200000X	Physical Therapy Assistant	014051	AZ

General Provider Information

NPI Number	:	1710563473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN D ONISKO PTA

Provider Business Mailing Address
First Line	:	11515 N 91ST ST UNIT 220
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-6899
Country	:	US
Telephone Number	:	480-209-0922
Fax Number	:

Provider Business Practice Location Address
First Line	:	7171 E LONE MOUNTAIN RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-5701
Country	:	US
Telephone Number	:	480-488-0309
Fax Number	:

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

Provider Enumeration Date	:	03/23/2021
Last Update Date	:	03/23/2021

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Directions to “ BRIAN D ONISKO PTA” Practice Location

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