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NPI Code Detail

MEDICARE: POLARIS PHYSICAL THERAPY P.C.

MEDICARE: POLARIS PHYSICAL THERAPY P.C.
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
12251X0800XOrthopedic Physical Therapist3974AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0299910OTHERAZBCBS OF ARIZONA

General Provider Information

NPI Number : 1184628562
Entity Type Code : Organization
Provider Name (Legal Business Name) : POLARIS PHYSICAL THERAPY P.C.
Provider Business Mailing Address
First Line : 2404 E RIVER ROAD
Second Line :
City : TUCSON
State : AZ
Zip : 85718
Country : US
Telephone Number : 520-408-9868
Fax Number : 520-300-7020
Provider Business Practice Location Address
First Line : 2404 E RIVER ROAD
Second Line :
City : TUCSON
State : AZ
Zip : 85718
Country : US
Telephone Number : 520-408-9868
Fax Number : 520-300-7020
Authorized Official
Title or Position : OWNER
Name : MATTHEW LINCOLN SPARROW
Credential : M.P.T.
Telephone Number : 520-408-9868
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/24/2014

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Directions to “POLARIS PHYSICAL THERAPY P.C. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.