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General NPI Number Information
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NPI Number | 1811954803
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Entity Type | Organization
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Legal Business Name | TIPTON PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 8400 E FLORENTINE RD
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-8653
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Country | US
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Telephone | 928-775-9999
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Fax | 928-775-9998
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Provider Business Mailing Address
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Address Line | 8400 E FLORENTINE RD
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-8653
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Country | US
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Telephone | 928-775-9999
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Fax | 928-775-9998
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Authorized Official
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Title or Position | MEDICAL BILLING
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Name | MS. ANITA ANN PHELPS
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Credential |
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Telephone | 928-775-9999
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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 | 5049
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License Number State | AZ
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