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General NPI Number Information
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NPI Number | 1548743784
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Entity Type | Individual
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Provider Name | RANAE NITURA CA, RYT, PT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 7950 E REDFIELD RD STE 160
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6935
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Country | US
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Telephone | 623-693-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 28946 N 124TH GLN
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City | PEORIA
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State | AZ
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Zip | 85383-0367
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Country | US
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Telephone | 623-693-0234
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | PH15CAT04063
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License Number State | NY
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