Healthcare Provider Details

I. General information

NPI: 1679823157
Provider Name (Legal Business Name): JOHN RHODES PHYSICAL THERAPY, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 E LEXINGTON AVE
PHOENIX AZ
85012-2321
US

IV. Provider business mailing address

219 E LEXINGTON AVE
PHOENIX AZ
85012-2321
US

V. Phone/Fax

Practice location:
  • Phone: 602-264-0694
  • Fax: 602-279-1128
Mailing address:
  • Phone: 602-264-0694
  • Fax: 602-279-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number536
License Number StateAZ

VIII. Authorized Official

Name: MR. JOHN MOSER RHODES
Title or Position: OWNER
Credential: PT, LAC
Phone: 602-264-0694