Healthcare Provider Details

I. General information

NPI: 1134138076
Provider Name (Legal Business Name): THERAPRO PHYSICAL THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 W BASELINE RD #109
LAVEEN AZ
85339-7327
US

IV. Provider business mailing address

3230 E BASELINE RD #101
PHOENIX AZ
85042-7133
US

V. Phone/Fax

Practice location:
  • Phone: 602-605-8982
  • Fax: 602-237-8861
Mailing address:
  • Phone: 602-438-9773
  • Fax: 602-438-9776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: EVA KARIN ORSO
Title or Position: OWNER
Credential: PT
Phone: 480-855-2884