Healthcare Provider Details

I. General information

NPI: 1154363638
Provider Name (Legal Business Name): CAREFREE PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7208 E CAVE CREEK RD SUITE H
CAREFREE AZ
85377-9600
US

IV. Provider business mailing address

PO BOX 5924
CAREFREE AZ
85377-5924
US

V. Phone/Fax

Practice location:
  • Phone: 480-488-9095
  • Fax: 480-488-2862
Mailing address:
  • Phone: 480-488-9095
  • Fax: 480-488-2862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY KISH
Title or Position: OFFICE MANAGER
Credential:
Phone: 480-488-9095