Healthcare Provider Details
I. General information
NPI: 1407851322
Provider Name (Legal Business Name): TUCSON PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2005
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5501 N ORACLE RD STE 101
TUCSON AZ
85704-3850
US
IV. Provider business mailing address
5501 N ORACLE RD STE 101
TUCSON AZ
85704-3850
US
V. Phone/Fax
- Phone: 520-293-5551
- Fax:
- Phone: 520-293-5551
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENNIS
A
DRISCOLL
Title or Position: PRESIDENT
Credential: PT
Phone: 520-293-5551