MEDICARE: CARLY SIKO PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305215241	VA
2	225100000X	Physical Therapist	034249	AZ

General Provider Information

NPI Number	:	1093434326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY SIKO PT, DPT

Provider Business Mailing Address
First Line	:	25101 N LAKE PLEASANT PKWY STE B-1340
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-1386
Country	:	US
Telephone Number	:	623-471-5550
Fax Number	:

Provider Business Practice Location Address
First Line	:	25101 N LAKE PLEASANT PKWY STE B-1340
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-1386
Country	:	US
Telephone Number	:	623-471-5550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/15/2025

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Directions to “ CARLY SIKO PT, DPT” Practice Location

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