Healthcare Provider Details

I. General information

NPI: 1104486455
Provider Name (Legal Business Name): DESERT HILLS PHYSICAL THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20998 E DESERT HILLS BLVD
QUEEN CREEK AZ
85142-6937
US

IV. Provider business mailing address

20998 E DESERT HILLS BLVD
QUEEN CREEK AZ
85142-6937
US

V. Phone/Fax

Practice location:
  • Phone: 520-595-0506
  • Fax:
Mailing address:
  • Phone: 520-595-0506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JAMES WHITE
Title or Position: OWNER
Credential: PT
Phone: 520-595-0506