Healthcare Provider Details

I. General information

NPI: 1568512754
Provider Name (Legal Business Name): REGINALD R MARQUEZ P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 E GREENWAY PKWY SUITE 100A
SCOTTSDALE AZ
85254-2073
US

IV. Provider business mailing address

9475 E IRONWOOD SQUARE DR STE 100
SCOTTSDALE AZ
85258-4576
US

V. Phone/Fax

Practice location:
  • Phone: 866-301-3347
  • Fax: 480-649-1638
Mailing address:
  • Phone: 480-778-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7471
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: