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General NPI Number Information
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NPI Number | 1023390069
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Entity Type | Individual
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Provider Name | COLLEEN COAKLEY PT, OCS, CIMT
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Gender | Female
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 7301 E 2ND ST STE 90
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5600
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Country | US
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Telephone | 480-994-1149
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Fax |
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Provider Business Mailing Address
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Address Line | 8324 E MACKENZIE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2811
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Country | US
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Telephone | 480-209-4855
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 4246
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License Number State | AZ
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