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General NPI Number Information
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NPI Number | 1669172193
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Entity Type | Organization
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Legal Business Name | EMBODY PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 03/03/2023
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Provider Practice Location Address
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Address Line | 3727 E ASTER DR
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City | PHOENIX
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State | AZ
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Zip | 85032-7328
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Country | US
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Telephone | 602-410-4716
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Fax |
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Provider Business Mailing Address
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Address Line | 3727 E ASTER DR
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City | PHOENIX
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State | AZ
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Zip | 85032-7328
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Country | US
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Telephone | 602-410-4716
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KATHERINE MARIE PRINCIC
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Credential | PT
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Telephone | 602-410-4716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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