Healthcare Provider Details

I. General information

NPI: 1770120305
Provider Name (Legal Business Name): EMPOWER PHOENIX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14627 N 60TH AVE
GLENDALE AZ
85306-3805
US

IV. Provider business mailing address

5830 W THUNDERBIRD RD STE B8
GLENDALE AZ
85306-4655
US

V. Phone/Fax

Practice location:
  • Phone: 928-233-6263
  • Fax: 480-781-4464
Mailing address:
  • Phone: 928-683-1392
  • Fax: 480-781-4464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MILES CHRISTENSON
Title or Position: OWNER
Credential: MS SLP
Phone: 928-683-1392