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General NPI Number Information
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NPI Number | 1508402124
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Entity Type | Organization
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Legal Business Name | MOMENTUM PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 14175 W INDIAN SCHOOL RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-8407
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Country | US
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Telephone | 602-567-7896
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Fax |
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Provider Business Mailing Address
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Address Line | 14175 W INDIAN SCHOOL RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-8407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST / OWNER
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Name | CRISTINA SPERRY
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Credential | PT
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Telephone | 602-567-7896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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