Healthcare Provider Details

I. General information

NPI: 1780755108
Provider Name (Legal Business Name): TAD PIECZYNSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10121 E BELL ROAD SUITE 140
SCOTTSDALE AZ
85260-2187
US

IV. Provider business mailing address

PO BOX 18607
FOUNTAIN HILLS AZ
85269-8607
US

V. Phone/Fax

Practice location:
  • Phone: 480-419-3500
  • Fax: 480-419-3522
Mailing address:
  • Phone: 480-419-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6569
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: