Healthcare Provider Details

I. General information

NPI: 1164034112
Provider Name (Legal Business Name): ADRIENNE FROST PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 W INDIAN SCHOOL RD STE 138
PHOENIX AZ
85037-1904
US

IV. Provider business mailing address

9150 W INDIAN SCHOOL RD STE 138
PHOENIX AZ
85037-1904
US

V. Phone/Fax

Practice location:
  • Phone: 970-759-5918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number014130
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number014130
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: