Healthcare Provider Details

I. General information

NPI: 1942878210
Provider Name (Legal Business Name): KRISTEN NICOLE URADZIONEK PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 10/28/2024
Certification Date: 06/14/2021
Deactivation Date: 06/14/2021
Reactivation Date: 10/28/2024

III. Provider practice location address

8850 E PIMA CENTER PKWY
SCOTTSDALE AZ
85258-4619
US

IV. Provider business mailing address

7100 W GRANDVIEW RD APT 2151
PEORIA AZ
85382-4928
US

V. Phone/Fax

Practice location:
  • Phone: 480-800-3900
  • Fax:
Mailing address:
  • Phone: 636-293-0817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31805
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: