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General NPI Number Information
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NPI Number | 1689853160
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Entity Type | Organization
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Legal Business Name | PHYSIOTHERAPY ASSOCIATES
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 16140 N ARROWHEAD FOUNTAINS CTR DR STE 105
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City | PEORIA
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State | AZ
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Zip | 85382-4789
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Country | US
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Telephone | 623-572-6776
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Fax |
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Provider Business Mailing Address
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Address Line | 16140 N ARROWHEAD FOUNTAINS CTR DR STE 105
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City | PEORIA
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State | AZ
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Zip | 85382-4789
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Country | US
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Telephone | 623-572-6776
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Fax |
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Authorized Official
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Title or Position | CERTIFIED ATHLETIC TRAINER
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Name | MISS TINA LOUISE BENALLY
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Credential | ATC/LAT
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Telephone | 623-572-6776
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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 | 0262
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License Number State | AZ
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