Healthcare Provider Details

I. General information

NPI: 1104048248
Provider Name (Legal Business Name): SPOONER PHYSICAL THERAPY & HAND REHAB, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 N 15TH AVE STE 401
PHOENIX AZ
85015-3332
US

IV. Provider business mailing address

9097 E DESERT COVE AVE STE 110
SCOTTSDALE AZ
85260-6276
US

V. Phone/Fax

Practice location:
  • Phone: 602-285-0949
  • Fax: 602-285-0052
Mailing address:
  • Phone: 602-285-0949
  • Fax: 602-285-0052

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: TIMOTHY A SPOONER
Title or Position: PRESIDENT
Credential: PT
Phone: 480-551-4958