Healthcare Provider Details

I. General information

NPI: 1649507591
Provider Name (Legal Business Name): STAR THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 W FRONTIER ST
APACHE JUNCTION AZ
85120-9084
US

IV. Provider business mailing address

1265 W FRONTIER ST
APACHE JUNCTION AZ
85120-9084
US

V. Phone/Fax

Practice location:
  • Phone: 480-773-5383
  • Fax: 480-209-1494
Mailing address:
  • Phone: 480-773-5383
  • Fax: 480-209-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3295
License Number StateAZ

VIII. Authorized Official

Name: MS. RITA TROXTEL
Title or Position: CEO/OWNER
Credential: OTD
Phone: 480-773-5383