Healthcare Provider Details

I. General information

NPI: 1871464347
Provider Name (Legal Business Name): ZACHARY PRATHER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 N LA CANADA DR STE 160
TUCSON AZ
85737-7047
US

IV. Provider business mailing address

10550 N LA CANADA DR STE 160
TUCSON AZ
85737-7047
US

V. Phone/Fax

Practice location:
  • Phone: 520-547-2476
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP059434T
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: