Healthcare Provider Details

I. General information

NPI: 1407760986
Provider Name (Legal Business Name): BS PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3935 W 20TH LN
YUMA AZ
85364-5862
US

IV. Provider business mailing address

3935 W 20TH LN
YUMA AZ
85364-5862
US

V. Phone/Fax

Practice location:
  • Phone: 928-384-3827
  • Fax:
Mailing address:
  • Phone: 928-384-3827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: BROOKE CARAGATA
Title or Position: PHYSICAL THERAPIST/CLINICAL MANAGER
Credential: DPT
Phone: 928-388-9897