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General NPI Number Information
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NPI Number | 1679852289
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Entity Type | Organization
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Legal Business Name | BRANSON PHYSICAL THERAPY A ARIZONA LLC
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 850 S IRONWOOD DR SUITE 112
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-6242
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Country | US
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Telephone | 480-983-1680
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Fax | 480-983-1681
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Provider Business Mailing Address
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Address Line | 850 S IRONWOOD DR SUITE 112
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-6242
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Country | US
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Telephone | 480-983-1680
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Fax | 480-983-1681
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. GARRY W BRANSON
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Credential | DPT
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Telephone | 480-983-1680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 3316
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License Number State | AZ
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