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NPI Code Detail

MEDICARE: KOKI K AMIN DPT

MEDICARE:   KOKI K AMIN  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
1174400000XSpecialist8041AZ
2225100000XPhysical Therapist8041AZ

General Provider Information

NPI Number : 1215103080
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOKI K AMIN DPT
Provider Business Mailing Address
First Line : 643 W SAN CARLOS WAY
Second Line :
City : CHANDLER
State : AZ
Zip : 85248
Country : US
Telephone Number : 480-882-0766
Fax Number : 480-374-5287
Provider Business Practice Location Address
First Line : 643 W SAN CARLOS WAY
Second Line :
City : CHANDLER
State : AZ
Zip : 85248-5173
Country : US
Telephone Number : 480-882-0766
Fax Number : 480-374-5287
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2008
Last Update Date : 07/27/2017

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Directions to “ KOKI K AMIN DPT” Practice Location

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