Healthcare Provider Details

I. General information

NPI: 1457020927
Provider Name (Legal Business Name): OMAR DURRANI PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: OMAR DURRANI PT, DPT

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9508 E RIGGS RD
SUN LAKES AZ
85248-7531
US

IV. Provider business mailing address

7310 N 16TH ST STE 100
PHOENIX AZ
85020-5259
US

V. Phone/Fax

Practice location:
  • Phone: 480-883-2000
  • Fax:
Mailing address:
  • Phone: 602-535-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number31982
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: