Healthcare Provider Details

I. General information

NPI: 1760025621
Provider Name (Legal Business Name): ARIZONA ORTHOPEDIC PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 W GUADALUPE RD
GILBERT AZ
85233-3200
US

IV. Provider business mailing address

14557 W INDIAN SCHOOL RD
GOODYEAR AZ
85395-9218
US

V. Phone/Fax

Practice location:
  • Phone: 623-242-6908
  • Fax: 623-242-6909
Mailing address:
  • Phone: 623-242-6908
  • Fax: 623-242-6909

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: DR. RYANN P ROBERTS
Title or Position: OWNER
Credential: DPT
Phone: 623-242-6908