Healthcare Provider Details

I. General information

NPI: 1356720957
Provider Name (Legal Business Name): ALICIA KRAUSE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9097 E DESERT COVE AVE SUITE 110
SCOTTSDALE AZ
85260-6279
US

IV. Provider business mailing address

PO BOX 4570
SCOTTSDALE AZ
85261-4570
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-4298
  • Fax: 480-860-0165
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11566
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: