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NPI Code Detail

MEDICARE: DR. NICOLE TERIBERY PT, DPT

MEDICARE: DR. NICOLE TERIBERY 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
1225100000XPhysical TherapistPT36233FL
22251X0800XOrthopedic Physical TherapistLPT-33227AZ

General Provider Information

NPI Number : 1144832650
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE TERIBERY PT, DPT
Provider Business Mailing Address
First Line : 4800 N 44TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-3800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4800 N 44TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-3800
Country : US
Telephone Number : 602-808-8989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2020
Last Update Date : 09/04/2023

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