Healthcare Provider Details

I. General information

NPI: 1649485269
Provider Name (Legal Business Name): DESERT VIEW PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6641 E BAYWOOD AVE SUITE A 4
MESA AZ
85206-1723
US

IV. Provider business mailing address

6641 E BAYWOOD AVE SUITE A 4
MESA AZ
85206-1723
US

V. Phone/Fax

Practice location:
  • Phone: 480-396-9020
  • Fax: 480-218-9182
Mailing address:
  • Phone: 480-396-9020
  • Fax: 480-218-9182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: RANDY MIKKEL BRATRUD
Title or Position: PHYSICAL THERAPIST
Credential: P.T.
Phone: 480-396-9020