Healthcare Provider Details
I. General information
NPI: 1033737119
Provider Name (Legal Business Name): ONOFRAY PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2020
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2418 W BENT TREE DR
PHOENIX AZ
85085-4738
US
IV. Provider business mailing address
2418 W BENT TREE DR
PHOENIX AZ
85085-4738
US
V. Phone/Fax
- Phone: 314-265-2688
- Fax:
- Phone: 314-265-2688
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251E1200X |
| Taxonomy | Ergonomics Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251H1300X |
| Taxonomy | Human Factors Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251S0007X |
| Taxonomy | Sports Physical Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEGAN
ONOFRAY
Title or Position: PHYSICAL THERAPIST, OWNER
Credential: PT
Phone: 314-265-1688