Healthcare Provider Details

I. General information

NPI: 1467378422
Provider Name (Legal Business Name): APRIL BAHAREH FETSKO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20950 N TATUM BLVD STE 390
PHOENIX AZ
85050-4258
US

IV. Provider business mailing address

6850 E MAYO BLVD UNIT 2223
PHOENIX AZ
85054-5689
US

V. Phone/Fax

Practice location:
  • Phone: 148-058-7748
  • Fax:
Mailing address:
  • Phone: 909-736-7244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-033779
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: