Healthcare Provider Details
I. General information
NPI: 1023358512
Provider Name (Legal Business Name): THERAPY ACCOMPLISHED LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2013
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11071 S CAMELBACK ROAD
YUCCA AZ
86438-0155
US
IV. Provider business mailing address
PO BOX 155
YUCCA AZ
86438-0155
US
V. Phone/Fax
- Phone: 928-279-3652
- Fax: 888-446-5008
- Phone: 928-279-3652
- Fax: 888-446-5008
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PATRICIA
L
MCNEIL
Title or Position: OWNER/ PHYSICAL THERAPIST
Credential: PT
Phone: 928-279-3652