MEDICARE: MR. VINCENT DALE KAME P.T.

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	2252	AZ

General Provider Information

NPI Number	:	1114920642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT DALE KAME P.T.

Provider Business Mailing Address
First Line	:	7100 E LINCOLN DR
Second Line	:	STE A101
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85253-4433
Country	:	US
Telephone Number	:	480-609-0822
Fax Number	:	480-609-0828

Provider Business Practice Location Address
First Line	:	7100 E LINCOLN DR
Second Line	:	STE A101
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85253-4433
Country	:	US
Telephone Number	:	480-609-0822
Fax Number	:	480-609-0828

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	07/08/2007

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