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General NPI Number Information
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NPI Number | 1811042914
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Entity Type | Individual
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Provider Name | MICHELLE R. PIPKE B.S. P. T.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17999 W. SURPRISE FARMS LOOP SOUTH
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City | SURPRISE
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State | AZ
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Zip | 85388
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Country | US
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Telephone | 623-876-7388
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Fax |
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Provider Business Mailing Address
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Address Line | 3637 W CHARLESTON AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-2808
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Country | US
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Telephone | 602-561-5213
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 2536
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License Number State | AZ
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