Healthcare Provider Details

I. General information

NPI: 1831994391
Provider Name (Legal Business Name): MCKENNA ALVAREZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26900 N LAKE PLEASANT PKWY STE 120
PEORIA AZ
85383-1590
US

IV. Provider business mailing address

14287 N 87TH ST STE 220
SCOTTSDALE AZ
85260-3698
US

V. Phone/Fax

Practice location:
  • Phone: 623-400-9100
  • Fax:
Mailing address:
  • Phone: 480-937-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number034069
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: