Healthcare Provider Details

I. General information

NPI: 1962579292
Provider Name (Legal Business Name): STEFANIE ELIZABETH REID DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEFANIE ELIZABETH LAMON DPT

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 S WATSON RD STE 118
BUCKEYE AZ
85326-3468
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 623-212-1040
  • Fax: 623-212-1041
Mailing address:
  • Phone: 480-937-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5735024
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number27705
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5735-024
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCPO32979T
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: