Healthcare Provider Details

I. General information

NPI: 1114851714
Provider Name (Legal Business Name): VALLEY PERFORMANCE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6311 N 7TH ST
PHOENIX AZ
85014-1551
US

IV. Provider business mailing address

5225 W SAN GABRIEL AVE
LAVEEN AZ
85339-5411
US

V. Phone/Fax

Practice location:
  • Phone: 503-706-3294
  • Fax:
Mailing address:
  • Phone: 503-706-3294
  • 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: KAYLA SCOTCH
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 503-706-3294