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General NPI Number Information
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NPI Number | 1336149723
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Entity Type | Organization
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Legal Business Name | CACTUS PHYSICAL THERAPY LIMITED, INC.
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 34155 N SCOTTSDALE RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85262-1221
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Country | US
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Telephone | 480-488-7018
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Fax | 623-465-7653
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Provider Business Mailing Address
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Address Line | PO BOX 5914
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City | CAREFREE
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State | AZ
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Zip | 85377-5914
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Country | US
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Telephone | 623-465-7653
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Fax | 623-465-7653
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Authorized Official
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Title or Position | V.P./SECRETARY & STATUTORY AGENT
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Name | DR. RICHARD L. PAINCHAUD
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Credential | PH.D.
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Telephone | 623-465-7653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | AZ #617
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License Number State | AZ
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