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General NPI Number Information
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NPI Number | 1881365161
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Entity Type | Organization
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Legal Business Name | CORRECTIVE PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 09/25/2021
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Provider Practice Location Address
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Address Line | 18700 N 107TH AVE STE 8
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City | SUN CITY
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State | AZ
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Zip | 85373-9759
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Country | US
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Telephone | 602-615-0624
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 W MCLELLAN RD
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City | MESA
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State | AZ
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Zip | 85201-2038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MATTHEW BROWN
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Credential | DPT
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Telephone | 602-615-0624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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