Healthcare Provider Details

I. General information

NPI: 1396093084
Provider Name (Legal Business Name): SAEED MONTERREY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4703 S LAKESHORE DR STE 2
TEMPE AZ
85282
US

IV. Provider business mailing address

4703 S LAKESHORE DR STE 2
TEMPE AZ
85282-7159
US

V. Phone/Fax

Practice location:
  • Phone: 480-718-9493
  • Fax:
Mailing address:
  • Phone: 480-718-9493
  • Fax: 480-773-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9950
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: