Healthcare Provider Details

I. General information

NPI: 1447547815
Provider Name (Legal Business Name): JEFFREY PETER FOUCRIER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9097 E DESERT COVE AVE SUITE 110
SCOTTSDALE AZ
85260-6710
US

IV. Provider business mailing address

9097 E DESERT COVE AVE SUITE 110
SCOTTSDALE AZ
85260-6710
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10032
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1377
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: