Healthcare Provider Details

I. General information

NPI: 1063609477
Provider Name (Legal Business Name): O'BRIEN PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 E CHAUNCEY LN STE 115
PHOENIX AZ
85054-5160
US

IV. Provider business mailing address

6910 E CHAUNCEY LN STE 115
PHOENIX AZ
85054-5160
US

V. Phone/Fax

Practice location:
  • Phone: 602-538-6736
  • Fax:
Mailing address:
  • Phone: 602-538-6736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK JOHN O'BRIEN
Title or Position: OWNER-PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 602-538-6736