Healthcare Provider Details

I. General information

NPI: 1003725888
Provider Name (Legal Business Name): BRENDON HARRINGTON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20700 N 55TH ST UNIT 438
PHOENIX AZ
85054-0048
US

IV. Provider business mailing address

20700 N 55TH ST UNIT 438
PHOENIX AZ
85054-0048
US

V. Phone/Fax

Practice location:
  • Phone: 818-359-0031
  • Fax:
Mailing address:
  • Phone: 818-359-0031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-034938
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: