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General NPI Number Information
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NPI Number | 1750099214
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Entity Type | Organization
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Legal Business Name | B. THERAPY LLC
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 4494 W PEORIA AVE STE 115A
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City | GLENDALE
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State | AZ
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Zip | 85302-2020
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Country | US
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Telephone | 314-440-7583
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Fax |
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Provider Business Mailing Address
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Address Line | 6968 W PALO VERDE DR
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City | GLENDALE
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State | AZ
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Zip | 85303-4405
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Country | US
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Telephone | 314-913-4690
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VICKY CHAVIS
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Credential | LPN, CWCA, CLT
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Telephone | 314-913-4690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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