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General NPI Number Information
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NPI Number | 1720296346
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Entity Type | Individual
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Provider Name | VINCENT PRAKASH PERIES JR. DPT
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 9475 E IRONWOOD SQUARE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4576
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Country | US
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Telephone | 480-778-1400
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Fax | 480-778-0400
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Provider Business Mailing Address
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Address Line | 5039 E LUCIA DR
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City | CAVE CREEK
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State | AZ
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Zip | 85331-2338
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Country | US
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Telephone | 480-220-0811
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6488
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 6488
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 6488
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License Number State | AZ
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