Healthcare Provider Details

I. General information

NPI: 1205759883
Provider Name (Legal Business Name): EMILY SOGAN DPT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13385 W MCDOWELL RD
GOODYEAR AZ
85395-2631
US

IV. Provider business mailing address

17722 W JOJOBA RD
GOODYEAR AZ
85338-6500
US

V. Phone/Fax

Practice location:
  • Phone: 623-986-5110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-034863
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: