Healthcare Provider Details

I. General information

NPI: 1215266077
Provider Name (Legal Business Name): THOMAS SCHEUB OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W THOMAS RD SUITE 301
PHOENIX AZ
85013-4407
US

IV. Provider business mailing address

FILE 56765
LOS ANGELES CA
90074-6765
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-6262
  • Fax: 602-406-6260
Mailing address:
  • Phone: 602-406-3860
  • Fax: 602-406-6132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2925
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: