Healthcare Provider Details

I. General information

NPI: 1598489122
Provider Name (Legal Business Name): MORGAN HUPPENTHAL PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5616 E MAIN ST
MESA AZ
85205-8813
US

IV. Provider business mailing address

3203 N ELLIS ST
CHANDLER AZ
85224-1049
US

V. Phone/Fax

Practice location:
  • Phone: 480-710-3489
  • Fax:
Mailing address:
  • Phone: 480-710-3489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MORGAN HUPPENTHAL
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 480-710-3489