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General NPI Number Information
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NPI Number | 1689036196
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Entity Type | Organization
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Legal Business Name | POOL THERAPY PLUS, PLLC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 353 CIMARRON CT
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City | PRESCOTT
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State | AZ
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Zip | 86301-1563
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Country | US
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Telephone | 928-227-2364
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Fax | 928-233-6932
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Provider Business Mailing Address
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Address Line | 353 CIMARRON CT
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City | PRESCOTT
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State | AZ
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Zip | 86301-1563
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Country | US
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Telephone | 928-227-2364
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Fax | 928-233-6932
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARBARA KAY BUTLER
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Credential | PT
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Telephone | 928-227-2364
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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 | 6690
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License Number State | AZ
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