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General NPI Number Information
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NPI Number | 1871577494
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Entity Type | Individual
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Provider Name | DAVID ELI HAWKINS M.S.P.T
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Gender | Male
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 17235 N 75TH AVE STE E145
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City | GLENDALE
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State | AZ
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Zip | 85308
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Country | US
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Telephone | 623-201-7210
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Fax | 236-201-7214
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Provider Business Mailing Address
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Address Line | 17235 N 75TH AVE STE E145
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City | GLENDALE
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State | AZ
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Zip | 85308-0867
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Country | US
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Telephone | 623-201-7210
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Fax | 623-201-7214
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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 | 8768
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1466
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License Number State | NV
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