Healthcare Provider Details

I. General information

NPI: 1699198481
Provider Name (Legal Business Name): SPOONER PHYSICAL THERAPY & HAND REHAB, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 N 113TH AVE STE 106
AVONDALE AZ
85392-3938
US

IV. Provider business mailing address

14287 N 87TH ST STE 220
SCOTTSDALE AZ
85260-3698
US

V. Phone/Fax

Practice location:
  • Phone: 623-772-7748
  • Fax: 623-772-7749
Mailing address:
  • Phone: 623-772-7748
  • Fax: 623-772-7749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY A SPOONER
Title or Position: PRESIDENT
Credential: PT
Phone: 480-551-4958