Healthcare Provider Details

I. General information

NPI: 1902037005
Provider Name (Legal Business Name): MONICA L ZHOVKLYY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA L BEARD PT

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 9110
SELLS AZ
85634-9744
US

IV. Provider business mailing address

1590 E RACINE DR
CASA GRANDE AZ
85122-6412
US

V. Phone/Fax

Practice location:
  • Phone: 520-361-1800
  • Fax: 520-361-3656
Mailing address:
  • Phone: 520-361-1800
  • Fax: 520-361-3656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8564
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: