Healthcare Provider Details

I. General information

NPI: 1275605727
Provider Name (Legal Business Name): BRIAN PAUL DOORLEY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 W DUNLAP AVE STE 145
PHOENIX AZ
85021-2813
US

IV. Provider business mailing address

3402 N WARREN DRIVE
ANTHEM AZ
85086
US

V. Phone/Fax

Practice location:
  • Phone: 602-870-1414
  • Fax: 602-870-4141
Mailing address:
  • Phone: 623-551-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberLPT-004054
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: