Healthcare Provider Details

I. General information

NPI: 1194852673
Provider Name (Legal Business Name): HYRUM R TENNEY P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RICH TENNEY PT

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E GURLEY ST
PRESCOTT AZ
86301-3823
US

IV. Provider business mailing address

281 MOUNTAIN MYRTLE CIR
PRESCOTT AZ
86301-5491
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-5400
  • Fax:
Mailing address:
  • Phone: 928-277-9003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number7612
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7612
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: