MEDICARE: DORLAND PHYSICAL THERAPY AND REHAB SPECIALISTS

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	5219	AZ

General Provider Information

NPI Number	:	1093728644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DORLAND PHYSICAL THERAPY AND REHAB SPECIALISTS

Provider Business Mailing Address
First Line	:	PO BOX 3497
Second Line	:
City	:	STURTEVANT
State	:	WI
Zip	:	53177-3497
Country	:	US
Telephone Number	:	877-552-2996
Fax Number	:	866-245-8064

Provider Business Practice Location Address
First Line	:	13629 W CAMINO DEL SOL
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-1405
Country	:	US
Telephone Number	:	866-476-3338
Fax Number	:	623-556-8106

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. DAVID C. DORLAND
Credential	:	MS,PT
Telephone Number	:	866-476-3338

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	02/26/2008

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